Endoscopic Evaluation and Treatment of Postoperative Bariatric Surgery Complications

Docimo, Salvatore; Svestka, Michael

doi:10.1177/1553350617736651

Cited by 11 publications

(15 citation statements)

References 73 publications

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“…Running title: APC TO TREAT WEIGHT REGAIN: RCT Ricardo José Fittipaldi-Fernandez 1 , Idiberto José Zotarelli-Filho 2,3,4* , Marcelo Falcão de Santana 5,6 , João Henrique Felicio de Lima 7 , Fernando Santos Silva Bastos 5,6 , Sérgio Alexandre Barrichello-Junior 8 , Newton Teixeira dos Santos 9 , Marcella Guedes 1 , Aline Fittipaldi-Fernandez 1…”

Section: Accepted Manuscriptunclassified

Roux-en-Y Gastric Bypass Pouch Outlet Reduction Using Argon Plasma Coagulation

Fittipaldi-Fernandez¹,

Zotarelli-Filho

Galvao

et al. 2023

Endosc Int Open

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Aims: A comparative study was conducted to evaluate the efficacy of argon plasma coagulation (APC) therapy in treating post-RYGB weight regain and the incidence of complications related to this procedure, using a sham treatment group as a control. Methods: Forty-one patients with a minimum weight regain of 10 kg and a minimum postoperative time of 36 months were randomized into two groups. Results: In the APC group (n=21), the mean initial weight was 100.4 kg and the mean weight regain was 24.94 kg. In the sham group (n=20), the mean initial weight was 103.65 kg, and the mean weight regain 25.18 kg. Anastomotic stenosis occurred only after the first APC session. The results for the comparison of APC with the sham group showed a percentage weight regain loss of 63.95 compared to -2.65, and weight loss of 15.02 and -0.57), percentage total weight loss of 14.46 and -0.62, excess weight loss of 54.32% and -2.34%), and BMI reduction of 5.38 and -0.21, with a p-value < 0.0001 for all the comparisons. In the APC group, there was a significant reduction in HbA1c (5.66% to 4.96%) and triglycerides (153.20 mg/dL to 132.20 mg/dL). Conclusion: This study indicates that APC outlet pouch reduction outperforms sham treatment in terms of weight loss for patients presenting weight regain after RYGB.

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Section: Accepted Manuscriptunclassified

Roux-en-Y Gastric Bypass Pouch Outlet Reduction Using Argon Plasma Coagulation

Fittipaldi-Fernandez¹,

Zotarelli-Filho

Galvao

et al. 2023

Endosc Int Open

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“…As deiscências representam uma das principais causas de mortes, sendo uma das mais sérias complicações relacionadas às gastroplastias. Tipicamente ocorrem poucos dias após a cirurgia, porém há relatos de uma apresentação mais arrastada e tardia (27)(28)(29) . A incidência estimada de deiscências após BPGY varia entre 1,7% e 2,5%, enquanto na GV varia de 0,7% até 5% (sendo principalmente próxima ao ângulo de His) (29) .…”

Section: Fístulas E Deiscênciasunclassified

“…Tipicamente ocorrem poucos dias após a cirurgia, porém há relatos de uma apresentação mais arrastada e tardia (27)(28)(29) . A incidência estimada de deiscências após BPGY varia entre 1,7% e 2,5%, enquanto na GV varia de 0,7% até 5% (sendo principalmente próxima ao ângulo de His) (29) . Em conjunto com embolia pulmonar, representam mais de 50% das causas de morte em pacientes submetidos à cirurgia bariátrica (27)(28)(29) .…”

Section: Fístulas E Deiscênciasunclassified

Complicações cirúrgicas após gastroplastias

Lima

Nóbrega²,

Santos

et al. 2020

RevCienti HMJMA

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O crescimento exuberante do volume de cirurgias bariátricas criou um contingente de pessoas que podem necessitar de atendimento em emergências pelas mais diversas causas, desde casos simples de desconforto abdominal até situações que podem evoluir de forma grave se não forem diagnosticados e tratados com agilidade e segurança. Apresentamos uma breve descrição das principais complicações cirúrgicas após gastroplastias, detalhando o quadro clínico, diagnóstico e terapêutica, com o intuito de despertar interesse no assunto. As alterações anatômicas do trânsito intestinal podem propiciar o surgimento de complicações específicas. Compreender a anatomia e fisiologia das cirurgias e das prováveis complicações possa em muito contribuir para o diagnóstico eficaz e conduta terapêutica efetiva a tempo de reduzir maiores agravantes.

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“…Long-term weight regain is observed in approximately 20% to 30% of patients [5]. Of these, approximately 58.9% present dilatation of the gastrojejunal anastomosis (GJA) [6,7]. In this sense, GJA directly influences the restrictive factor of bariatric surgery for delaying the progression of food, but its size is still controversial In this scenario, suturing is a technique that has been used for at least 4,000 years, has evolved in terms of the materials chosen.…”

Section: Introductionmentioning

confidence: 99%

Prospective randomized controlled trial of the closure of gastrojejunal anastomosis in RYGB with absorbable and inabsorbable thread

Júnior

Zotarelli-Filho

Quadros

et al. 2022

IJN

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Introduction: The Roux-en-Y gastric bypass (RYGB) is, currently, the most performed technique in Brazil. Suture threads are classified according to their degradation properties. Objective: To analyze the influence on the size of the gastrojejunal anastomosis performed in Roux-en-Y gastric bypass surgery, as well as the main complications with the use of absorbable or inabsorbable thread. Methods: This study followed a prospective and randomized clinical trial, initially with 40 participants, with only 37 participants being duly selected, 19 of whom underwent gastrojejunostomy closure with an absorbable (Abs) polydioxanone suture (PDS II®) and 18 with the inabsorbable (Inb) ETHIBOND®. Statistical analysis was performed using the ANOVA and logistic regression tools (p<0.05 significant). Results: General complications and Upper Digestive Endoscopy (UDE) were less frequent at the end of 12 months in both groups. At the end of twelve months, the number of complications of the Inb thread decreased considerably, while the number of complications of the Abs thread showed an increase in other complications, including marginal ulcer and intrusive thread. Despite this, there was no significant difference between groups in terms of total weight loss. There was no statistically significant difference between the final values of the anastomotic diameter. The percentage of weight loss over the 12 months was 33.77 ± 6.97% for the Inb group and 36.10 ± 4.89% for the Abs group (p<0.05). Conclusion: Both suture threads (Inb and Abs) presented similar complications and did not present significant differences between the values of weight, gastrojejunal anastomosis, and pouch.

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Endoscopic Evaluation and Treatment of Postoperative Bariatric Surgery Complications

Cited by 11 publications

References 73 publications

Roux-en-Y Gastric Bypass Pouch Outlet Reduction Using Argon Plasma Coagulation

Roux-en-Y Gastric Bypass Pouch Outlet Reduction Using Argon Plasma Coagulation

Complicações cirúrgicas após gastroplastias

Prospective randomized controlled trial of the closure of gastrojejunal anastomosis in RYGB with absorbable and inabsorbable thread

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