Background Both weight regain and dumping syndrome (DS) after Roux-en-Y gastric bypass (RYGB) have been related to the dilation of gastro-jejunal anastomosis. The aim of this study is to assess the safety and long-term efficacy of endoscopic transoral outlet reduction (TORe) for DS and/or weight regain after RYBG.Materials and Methods A retrospective analysis was performed on a prospective database. Sigstad's score, early and late Arts Dumping Score (ADS) questionnaires, absolute weight loss (AWL), percentage of total body weight loss (%TBWL), and percentage of excess weight loss (%EWL) were assessed at baseline and at 6, 12, and 24 months after TORe.Results Eighty-seven patients (median age 46 years, 79% female) underwent TORe. The median baseline BMI was 36.2 kg/m(2). Out of 87 patients, 58 were classified as "dumpers " due to Sigstad's score & GE; 7. The resolution rate of DS (Sigstad's score < 7) was 68.9%, 66.7%, and 57.2% at 6, 12, and 24 months after TORe, respectively. A significant decrease in Sigstad's score as well as in early and late ADS questionnaires was observed (p < 0.001). The median Sigstad's score dropped from 15 (11-8.5) pre-operatively to 2 (0-12) at 24 months. The %TBWL was 10.5%, 9.9%, and 8.1% at 6, 12, and 24 months, respectively. Further, "dumpers " with resolution of DS showed better weight loss results compared with those with persistent DS (p < 0.001). The only adverse event observed was a perigastric fluid collection successfully managed conservatively.Conclusion TORe is a minimally invasive treatment for DS and/or weight regain after RYGB, with evidence of long-term efficacy.

Pontecorvi, V., Matteo, M. V., Bove, V., De Siena, M., Giannetti, G., Carlino, G., Polidori, G., Vinti, L., Angelini, G., Iaconelli, A., Familiari, P., Raffaelli, M., Costamagna, G., Boskoski, I., Long-term Outcomes of Transoral Outlet Reduction (TORe) for Dumping Syndrome and Weight Regain After Roux-en-Y Gastric Bypass, <<OBESITY SURGERY>>, 2023; (N/A): N/A-N/A. [doi:10.1007/s11695-023-06466-w] [https://hdl.handle.net/10807/231290]

Long-term Outcomes of Transoral Outlet Reduction (TORe) for Dumping Syndrome and Weight Regain After Roux-en-Y Gastric Bypass

Pontecorvi, Valerio;Matteo, Maria Valeria;Bove, Vincenzo;De Siena, Martina;Giannetti, Giulia;Carlino, Giorgio;Angelini, Giulia;Iaconelli, Amerigo;Familiari, Pietro;Raffaelli, Marco;Costamagna, Guido;Boskoski, Ivo
2023

Abstract

Background Both weight regain and dumping syndrome (DS) after Roux-en-Y gastric bypass (RYGB) have been related to the dilation of gastro-jejunal anastomosis. The aim of this study is to assess the safety and long-term efficacy of endoscopic transoral outlet reduction (TORe) for DS and/or weight regain after RYBG.Materials and Methods A retrospective analysis was performed on a prospective database. Sigstad's score, early and late Arts Dumping Score (ADS) questionnaires, absolute weight loss (AWL), percentage of total body weight loss (%TBWL), and percentage of excess weight loss (%EWL) were assessed at baseline and at 6, 12, and 24 months after TORe.Results Eighty-seven patients (median age 46 years, 79% female) underwent TORe. The median baseline BMI was 36.2 kg/m(2). Out of 87 patients, 58 were classified as "dumpers " due to Sigstad's score & GE; 7. The resolution rate of DS (Sigstad's score < 7) was 68.9%, 66.7%, and 57.2% at 6, 12, and 24 months after TORe, respectively. A significant decrease in Sigstad's score as well as in early and late ADS questionnaires was observed (p < 0.001). The median Sigstad's score dropped from 15 (11-8.5) pre-operatively to 2 (0-12) at 24 months. The %TBWL was 10.5%, 9.9%, and 8.1% at 6, 12, and 24 months, respectively. Further, "dumpers " with resolution of DS showed better weight loss results compared with those with persistent DS (p < 0.001). The only adverse event observed was a perigastric fluid collection successfully managed conservatively.Conclusion TORe is a minimally invasive treatment for DS and/or weight regain after RYGB, with evidence of long-term efficacy.
2023
Inglese
Pontecorvi, V., Matteo, M. V., Bove, V., De Siena, M., Giannetti, G., Carlino, G., Polidori, G., Vinti, L., Angelini, G., Iaconelli, A., Familiari, P., Raffaelli, M., Costamagna, G., Boskoski, I., Long-term Outcomes of Transoral Outlet Reduction (TORe) for Dumping Syndrome and Weight Regain After Roux-en-Y Gastric Bypass, <<OBESITY SURGERY>>, 2023; (N/A): N/A-N/A. [doi:10.1007/s11695-023-06466-w] [https://hdl.handle.net/10807/231290]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/231290
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