Long-term follow-up after transoral outlet reduction following Roux-en-Y gastric bypass: Back to stage 0?

Background and study aims Significant weight regain affects up to one-third of patients after Roux-en-Y gastric bypass (RYGB) and demands treatment. Transoral outlet reduction (TORe) with argon plasma coagulation (APC) alone or APC plus full-thickness suturing TORe (APC-FTS) is effective in the short term. However, no study has investigated the course of gastrojejunostomy (GJ) or quality of life (QOL) data after the first post-procedure year.Patients and methods Patients eligible for a 36-month follow-up visit after TORe underwent upper gastrointestinal endoscopy with measurement of the GJ and answered QOL questionnaires (RAND-36). The primary aim was to evaluate the long-term outcomes of TORe, including weight loss, QOL, and GJ anastomosis (GJA) size. Comparisons between APC and APC-FTS TORe were a secondary aim.Results Among 39 eligible patients, 29 returned for the 3-year follow-up visit. There were no significant differences in demographics between APC and APC-FTS TORe groups. At 3 years, patients from both groups regained all the weight lost at 12 months, and the GJ diameter was similar to the pre-procedure assessment. As to QOL, most improvements seen at 12 months were lost at 3 years, returning to pre-procedure levels. Only the energy/fatigue domain improvement was kept between the 1- and 3-year visits.Conclusions Obesity is a chronic relapsing disease. Most effects of TORe are lost at 3 years, and redilation of the GJA occurs. Therefore, TORe should be considered iterative rather than a one-off procedure.

URI

https://observatorio.fm.usp.br/handle/OPI/54685

Referências

Abu Dayyeh B, 2017, OBES SURG, V27, P1031, DOI 10.1007/s11695-016-2418-3
Abu Dayyeh BK, 2011, CLIN GASTROENTEROL H, V9, P228, DOI 10.1016/j.cgh.2010.11.004
Angrisani L, 2021, OBES SURG, V31, P1937, DOI 10.1007/s11695-020-05207-7
Baretta GAP, 2015, OBES SURG, V25, P72, DOI 10.1007/s11695-014-1363-2
Bauraite K, 2022, SURG ENDOSC, V36, P4333, DOI 10.1007/s00464-021-08778-3
Brunaldi VO, 2020, GASTROINTEST ENDOSC, V92, P97, DOI 10.1016/j.gie.2020.03.3757
Brunaldi VO, 2018, OBES SURG, V28, P266, DOI 10.1007/s11695-017-2986-x
Callahan ZM, 2020, SURG ENDOSC, V34, P2164, DOI 10.1007/s00464-019-07003-6
Cambi MPC, 2021, OBES SURG, V31, P1290, DOI 10.1007/s11695-020-05164-1
Carlsson LMS, 2020, NEW ENGL J MED, V383, P1535, DOI 10.1056/NEJMoa2002449
Chang TH, 2021, NUTRIENTS, V13, DOI 10.3390/nu13103668
Cooper TC, 2015, OBES SURG, V25, P1474, DOI 10.1007/s11695-014-1560-z
Eisenberg D, 2022, SURG OBES RELAT DIS, V18, P1345, DOI 10.1016/j.soard.2022.08.013
Neto MG, 2022, OBES SURG, V32, P273, DOI 10.1007/s11695-021-05795-y
Hays R D, 1993, Health Econ, V2, P217, DOI 10.1002/hec.4730020305
Jaruvongvanich V, 2020, GASTROINTEST ENDOSC, V92, P1164, DOI 10.1016/j.gie.2020.07.013
Jirapinyo P, 2020, GASTROINTEST ENDOSC, V91, P1067, DOI 10.1016/j.gie.2019.11.044
Jirapinyo P, 2017, BMJ OPEN GASTROENTER, V4, DOI 10.1136/bmjgast-2017-000153
Kumar N, 2016, GASTROINTEST ENDOSC, V83, P776, DOI 10.1016/j.gie.2015.08.039
Kuzminov A, 2016, OBES SURG, V26, P2237, DOI 10.1007/s11695-016-2252-7
Moon RC, 2018, OBES SURG, V28, P2737, DOI 10.1007/s11695-018-3229-5
Sampaio-Neto J, 2016, ABCD-ARQ BRAS CIR DI, V29, P12, DOI [10.1590/0102-6720201600S10004, 10.1590/0102-6720201600s10004]
Smith C, 2011, SURG ENDOSC, V25, P2164, DOI 10.1007/s00464-010-1516-x
Yanos BR, 2015, OBES SURG, V25, P1364, DOI 10.1007/s11695-014-1536-z
Zeigler Z, 2021, CURR OBES REP, V10, P423, DOI 10.1007/s13679-021-00449-7

Coleções

Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/35

Página do item completo