Endoscopic Dilation of Bariatric RNY Anastomotic Strictures: a Systematic Review and Meta-analysis
| Autor: | Max S. Fleisher, Anne Marie Carpenter, David S. Estores, Alexander L. Ayzengart, Alexandra J. Baumann, Lazarus K. Mramba, Russell B. Hawkins |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Nutrition and Dietetics Surgical complication business.industry Gastric bypass surgery Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Guideline Anastomosis medicine.disease_cause Surgery 03 medical and health sciences 0302 clinical medicine Meta-analysis medicine 030211 gastroenterology & hepatology Observational study business Complication Endoscopic dilation |
| Zdroj: | Obesity Surgery. 28:4053-4063 |
| ISSN: | 1708-0428 0960-8923 |
| Popis: | Gastrojejunostomy anastomotic strictures are a complication of Roux-en-Y gastric bypass surgery without an established treatment guideline. A systematic review and meta-analysis were performed to determine the safety and efficacy of endoscopic dilation in their management. PubMed, Web of Science, and Cochrane Central (1994-2017) were searched. Data was analyzed with random effects meta-analysis and mixed effects meta-regression. Twenty-one observational studies (896 patients) were included. The stricture rate for laparoscopic patients was 6% (95% CI, 5-9%). Only 38% (95% CI, 30-47%) required greater than one dilation. Symptom improvement occurred in 97% (95% CI, 94-98%). The complication rate was 4% (95% CI, 3-6%). Endoscopic dilation of GJA strictures is safe, effective, and sustaining. This study can guide endoscopists in the treatment of a common bariatric surgical complication. |
| Databáze: | OpenAIRE |
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