Endoscopic versus surgical gastrojejunal revision for weight regain in Roux-en-Y gastric bypass patients: 5-year safety and efficacy comparison
| Autor: | Christopher C. Thompson, Russell D. Dolan, Pichamol Jirapinyo |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Reoperation
medicine.medical_specialty Gastric bypass Gastric Bypass Weight Gain Article Cohort Studies symbols.namesake Weight regain Weight loss medicine Humans Radiology Nuclear Medicine and imaging Adverse effect Fisher's exact test Retrospective Studies business.industry Gastroenterology Roux-en-Y anastomosis Gastrojejunal anastomosis Obesity Morbid Surgery Treatment Outcome symbols medicine.symptom business Body mass index |
| Zdroj: | Gastrointest Endosc |
| ISSN: | 0016-5107 |
| Popis: | Background and Aims An enlarged gastrojejunal anastomosis (GJA) is associated with weight regain after Roux-en-Y gastric bypass (RYGB) and can be corrected with endoscopic or surgical revision; however, there has been no direct comparison between techniques. This study aims to compare serious adverse event (AE) rates and weight loss profiles between endoscopic and surgical revisional techniques over a 5-year period. Methods This is a retrospective matched cohort study of RYGB patients who underwent endoscopic or surgical revision for weight regain with an enlarged GJA (>12 mm). Patients who underwent endoscopic revision (ENDO group) were matched 1:1 to those undergoing surgical revision (SURG group) based on completion of 5-year follow-up, age, sex, body mass index, initial weight loss, and weight regain. Demographics, GJA size, serious AEs, and weight profiles were collected. The primary outcome was comparison of serious AE rates between groups. Secondary outcomes included weight loss comparisons. A Fisher exact test was used to compare the serious AE rate, and a Student t test was used for weight comparisons. Results Sixty-two RYGB patients with weight regain and an enlarged GJA (31 ENDO, 31 matched SURG) were included. Baseline characteristics were similar between groups. The AE rate in the ENDO group (6.5%) was lower than the SURG group (29.0%, P = .043). Zero and 6 (19.4%) serious (severe) AEs occurred in the ENDO and SURG groups, respectively (P = .02). There was no significant difference in weight loss at 1, 3, and 5 years. Conclusions Endoscopic revision of the GJA is associated with significantly fewer total and serious AEs and similar long-term weight loss when compared with surgical revision. |
| Databáze: | OpenAIRE |
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