Endoscopic Suturing for Transoral Outlet Reduction Increases Weight Loss After Roux-en-Y Gastric Bypass Surgery

Six month outcomes in patients experiencing weight gain after gastric bypass who underwent gastrojejunal revision using an endoluminal suturing device

“…In a multicenter, randomized sham-controlled trial evaluating the Bard Endocinch TM (C.R. Bard, Murray Hill, NJ), Thompson et al reported % EWL of 15.9 ± 20.9 % at 6 months [11]. In another multicenter study evaluating the restorative obesity surgery procedure endoluminally (ROSE) (USGI Medical, San Clemente, CA), Horgan et al reported % EWL of 18 ± 18 % at 6 months [13].…”

“…A recent multicenter randomized trial demonstrated that dilation of the gastrojejunal (GJ) anastomosis has been associated with weight regain after surgery [9,10]. In this trial, endoscopically reducing the diameter of the GJ stoma resulted in additional weight loss after RYGB [11]. This same trial speculated that superior results could potentially be achieved if a full-thickness suturing device was utilized.…”

Recent advancements in bariatric/metabolic surgery

“…Weight regain after LRYGB was related to dilatation of the gastric pouch and anastomosis 45, 46. Endoscopic treatment was developed recently and is recommended for first‐line treatment for those with weight regain after RYGB 47, 48. Weight loss after LRYGB was found to be similar or slightly better than with LSG but with more nutritional deficiencies in LRYGB 49, 50, 51.…”

Revisão sistemática e metanálise do tratamento endoscópico do reganho de peso pós-derivação gástrica em Y-de-Roux

“…Raros estudos apresentam algum grau de controle de vieses e mais raros ainda são aqueles controlados, dentre os quais os únicos representantes até o momento deste trabalho são Eid et al (2014) e Thompson et al (2013). Ambos compararam os procedimentos de sutura endoscópica com procedimentos fantasmas e demonstraram superioridade estatística favorecendo a sutura.…”

“…(Ryou et al, 2009;Mullady et al, 2009;Mikami et al, 2010;Hornag et al, 2010;Leitman et al, 2010;Raman et al, 2011;Thompson et al, 2012;Jiraponyo et al, 2013;Ong'uti et al, 2013;Sung et al, 2013;Goyal et al, 2013;Eid et al, 2014;Arellano, 2014;Kumar e Thompson, 2014ae 2014bGoyal et al, 2015;Landi et al, 2016;Gallo et al, 2016;Kumar e Thompson, 2016;Patel et al, 2016;Vargas et al, 2016;Schulman e Thompson, 2016;Riva et al, 2017); três, sutura de espessura parcial (SEP) (Roll e D'Assumção, 2010; Thompson et al, 2013;Kumar e Thompson, 2014a); dois estudos relataram uso de APC (Baretta et al, 2015;Fittipaldi-Fernadez e Diestel, 2015); e um de OTSC (Heylen et al, 2011). Nenhum estudo descrevendo a escleroterapia satisfez os critérios de elegibilidade.…”