Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass
Background The failure of approximately 20 % of obese patients who undergo Roux-en-Y gastric bypass (RYGB) to maintain weight loss over the following 18–24 months is related to the surgical procedure, to the patient, or both. Although the underlying mechanisms are uncertain, one factor that has been...
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| Veröffentlicht in: | Obesity surgery 2015, Vol.25 (1), p.72-79 |
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| creator | Baretta, Giorgio A. P. Alhinho, Helga C. A. W. Matias, Jorge Eduardo F. Marchesini, João Batista de Lima, João Henrique F. Empinotti, Celso Campos, Josemberg M. |
| description | Background
The failure of approximately 20 % of obese patients who undergo Roux-en-Y gastric bypass (RYGB) to maintain weight loss over the following 18–24 months is related to the surgical procedure, to the patient, or both. Although the underlying mechanisms are uncertain, one factor that has been postulated is the dilation of the gastrojejunal anastomosis. The objective was to evaluate the safety and efficacy of the serial use of argon plasma coagulation (APC) in reducing the diameter of the dilated gastrojejunal anastomosis and post-RYGB weight regain.
Methods
We carried out a prospective, nonrandomized study of 30 patients, with no control or sham group, monitoring RYGB weight regain associated with dilation of the gastrojejunal anastomosis over a postoperative period of 18 months. Each patient underwent three sessions of APC in the anastomosis separated by 8 weeks, with a final endoscopic examination 8 weeks after the last session.
Results
There was a loss of 15.48 kg (range = 8.0–16.0 kg) of the 19.6 kg (range = 7.0–39.0 kg) of regained weight after RYGB and a reduction of 66.89 % in the final anastomotic diameter, with statistically significant reductions between each APC session. Previous body mass index significantly decreased up to the final examination, and the final weight was close to but not at the same level as the nadir.
Conclusions
Our study indicates that the use of APC to treat weight regain after RYGB is a safe and effective procedure and promotes a reduction in gastrojejunal anastomosis, final weight, and BMI, with a low rate of complications. |
| doi_str_mv | 10.1007/s11695-014-1363-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1640328838</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1640328838</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-2d99fba3eaba8f21e1db1a268adfe66a3cba70e9c45409c2e4feebcba07496433</originalsourceid><addsrcrecordid>eNp1kMFq3DAQhkVoabZpHyCXIuglF7fSyCtLx82SJoFAS2nppSDG3pHrxbY2kn3I20eL0xICPQmNvv8f9DF2LsUnKUT1OUmp7boQsiyk0qqAE7aSlTCFKMG8YithtSiMBXXK3qa0FwKkBnjDTmEtxNpIWLHfm9iGkX_rMQ3ItwHbucepy6Pg-TWmKYY97ecRe74Z8zUMIXWJ-xD5L-raPxP_Ti12I9_4ieKS6Bp--XDAlN6x1x77RO-fzjP288vVj-1Ncff1-na7uSsaVcFUwM5aX6MirNF4kCR3tUTQBneetEbV1FgJsk25LoVtgEpPVOehqEqrS6XO2MXSe4jhfqY0uaFLDfU9jhTm5KQuhQJjlMnoxxfoPswxf-9IKaskKH2k5EI1MaQUybtD7AaMD04Kd1TvFvUuq3dH9Q5y5sNT81wPtPuX-Os6A7AAKT-NLcVnq__b-ghiWo8a</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1639312368</pqid></control><display><type>article</type><title>Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Baretta, Giorgio A. P. ; Alhinho, Helga C. A. W. ; Matias, Jorge Eduardo F. ; Marchesini, João Batista ; de Lima, João Henrique F. ; Empinotti, Celso ; Campos, Josemberg M.</creator><creatorcontrib>Baretta, Giorgio A. P. ; Alhinho, Helga C. A. W. ; Matias, Jorge Eduardo F. ; Marchesini, João Batista ; de Lima, João Henrique F. ; Empinotti, Celso ; Campos, Josemberg M.</creatorcontrib><description>Background
The failure of approximately 20 % of obese patients who undergo Roux-en-Y gastric bypass (RYGB) to maintain weight loss over the following 18–24 months is related to the surgical procedure, to the patient, or both. Although the underlying mechanisms are uncertain, one factor that has been postulated is the dilation of the gastrojejunal anastomosis. The objective was to evaluate the safety and efficacy of the serial use of argon plasma coagulation (APC) in reducing the diameter of the dilated gastrojejunal anastomosis and post-RYGB weight regain.
Methods
We carried out a prospective, nonrandomized study of 30 patients, with no control or sham group, monitoring RYGB weight regain associated with dilation of the gastrojejunal anastomosis over a postoperative period of 18 months. Each patient underwent three sessions of APC in the anastomosis separated by 8 weeks, with a final endoscopic examination 8 weeks after the last session.
Results
There was a loss of 15.48 kg (range = 8.0–16.0 kg) of the 19.6 kg (range = 7.0–39.0 kg) of regained weight after RYGB and a reduction of 66.89 % in the final anastomotic diameter, with statistically significant reductions between each APC session. Previous body mass index significantly decreased up to the final examination, and the final weight was close to but not at the same level as the nadir.
Conclusions
Our study indicates that the use of APC to treat weight regain after RYGB is a safe and effective procedure and promotes a reduction in gastrojejunal anastomosis, final weight, and BMI, with a low rate of complications.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-014-1363-2</identifier><identifier>PMID: 25005812</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Anastomosis, Roux-en-Y - adverse effects ; Anastomosis, Roux-en-Y - methods ; Argon Plasma Coagulation - adverse effects ; Argon Plasma Coagulation - methods ; Body Mass Index ; Dilatation, Pathologic - surgery ; Endoscopy - methods ; Female ; Gastric Bypass - adverse effects ; Gastric Bypass - methods ; Gastrointestinal surgery ; Humans ; Jejunum - surgery ; Male ; Medical procedures ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Obesity, Morbid - surgery ; Original Contributions ; Reoperation - methods ; Surgery ; Treatment Failure ; Treatment Outcome ; Weight ; Weight Gain ; Young Adult</subject><ispartof>Obesity surgery, 2015, Vol.25 (1), p.72-79</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-2d99fba3eaba8f21e1db1a268adfe66a3cba70e9c45409c2e4feebcba07496433</citedby><cites>FETCH-LOGICAL-c372t-2d99fba3eaba8f21e1db1a268adfe66a3cba70e9c45409c2e4feebcba07496433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-014-1363-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-014-1363-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27931,27932,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25005812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baretta, Giorgio A. P.</creatorcontrib><creatorcontrib>Alhinho, Helga C. A. W.</creatorcontrib><creatorcontrib>Matias, Jorge Eduardo F.</creatorcontrib><creatorcontrib>Marchesini, João Batista</creatorcontrib><creatorcontrib>de Lima, João Henrique F.</creatorcontrib><creatorcontrib>Empinotti, Celso</creatorcontrib><creatorcontrib>Campos, Josemberg M.</creatorcontrib><title>Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
The failure of approximately 20 % of obese patients who undergo Roux-en-Y gastric bypass (RYGB) to maintain weight loss over the following 18–24 months is related to the surgical procedure, to the patient, or both. Although the underlying mechanisms are uncertain, one factor that has been postulated is the dilation of the gastrojejunal anastomosis. The objective was to evaluate the safety and efficacy of the serial use of argon plasma coagulation (APC) in reducing the diameter of the dilated gastrojejunal anastomosis and post-RYGB weight regain.
Methods
We carried out a prospective, nonrandomized study of 30 patients, with no control or sham group, monitoring RYGB weight regain associated with dilation of the gastrojejunal anastomosis over a postoperative period of 18 months. Each patient underwent three sessions of APC in the anastomosis separated by 8 weeks, with a final endoscopic examination 8 weeks after the last session.
Results
There was a loss of 15.48 kg (range = 8.0–16.0 kg) of the 19.6 kg (range = 7.0–39.0 kg) of regained weight after RYGB and a reduction of 66.89 % in the final anastomotic diameter, with statistically significant reductions between each APC session. Previous body mass index significantly decreased up to the final examination, and the final weight was close to but not at the same level as the nadir.
Conclusions
Our study indicates that the use of APC to treat weight regain after RYGB is a safe and effective procedure and promotes a reduction in gastrojejunal anastomosis, final weight, and BMI, with a low rate of complications.</description><subject>Adult</subject><subject>Anastomosis, Roux-en-Y - adverse effects</subject><subject>Anastomosis, Roux-en-Y - methods</subject><subject>Argon Plasma Coagulation - adverse effects</subject><subject>Argon Plasma Coagulation - methods</subject><subject>Body Mass Index</subject><subject>Dilatation, Pathologic - surgery</subject><subject>Endoscopy - methods</subject><subject>Female</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastric Bypass - methods</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Jejunum - surgery</subject><subject>Male</subject><subject>Medical procedures</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Reoperation - methods</subject><subject>Surgery</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><subject>Weight</subject><subject>Weight Gain</subject><subject>Young Adult</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMFq3DAQhkVoabZpHyCXIuglF7fSyCtLx82SJoFAS2nppSDG3pHrxbY2kn3I20eL0xICPQmNvv8f9DF2LsUnKUT1OUmp7boQsiyk0qqAE7aSlTCFKMG8YithtSiMBXXK3qa0FwKkBnjDTmEtxNpIWLHfm9iGkX_rMQ3ItwHbucepy6Pg-TWmKYY97ecRe74Z8zUMIXWJ-xD5L-raPxP_Ti12I9_4ieKS6Bp--XDAlN6x1x77RO-fzjP288vVj-1Ncff1-na7uSsaVcFUwM5aX6MirNF4kCR3tUTQBneetEbV1FgJsk25LoVtgEpPVOehqEqrS6XO2MXSe4jhfqY0uaFLDfU9jhTm5KQuhQJjlMnoxxfoPswxf-9IKaskKH2k5EI1MaQUybtD7AaMD04Kd1TvFvUuq3dH9Q5y5sNT81wPtPuX-Os6A7AAKT-NLcVnq__b-ghiWo8a</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Baretta, Giorgio A. P.</creator><creator>Alhinho, Helga C. A. W.</creator><creator>Matias, Jorge Eduardo F.</creator><creator>Marchesini, João Batista</creator><creator>de Lima, João Henrique F.</creator><creator>Empinotti, Celso</creator><creator>Campos, Josemberg M.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2015</creationdate><title>Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass</title><author>Baretta, Giorgio A. P. ; Alhinho, Helga C. A. W. ; Matias, Jorge Eduardo F. ; Marchesini, João Batista ; de Lima, João Henrique F. ; Empinotti, Celso ; Campos, Josemberg M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-2d99fba3eaba8f21e1db1a268adfe66a3cba70e9c45409c2e4feebcba07496433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Anastomosis, Roux-en-Y - adverse effects</topic><topic>Anastomosis, Roux-en-Y - methods</topic><topic>Argon Plasma Coagulation - adverse effects</topic><topic>Argon Plasma Coagulation - methods</topic><topic>Body Mass Index</topic><topic>Dilatation, Pathologic - surgery</topic><topic>Endoscopy - methods</topic><topic>Female</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastric Bypass - methods</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Jejunum - surgery</topic><topic>Male</topic><topic>Medical procedures</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Reoperation - methods</topic><topic>Surgery</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><topic>Weight</topic><topic>Weight Gain</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baretta, Giorgio A. P.</creatorcontrib><creatorcontrib>Alhinho, Helga C. A. W.</creatorcontrib><creatorcontrib>Matias, Jorge Eduardo F.</creatorcontrib><creatorcontrib>Marchesini, João Batista</creatorcontrib><creatorcontrib>de Lima, João Henrique F.</creatorcontrib><creatorcontrib>Empinotti, Celso</creatorcontrib><creatorcontrib>Campos, Josemberg M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baretta, Giorgio A. P.</au><au>Alhinho, Helga C. A. W.</au><au>Matias, Jorge Eduardo F.</au><au>Marchesini, João Batista</au><au>de Lima, João Henrique F.</au><au>Empinotti, Celso</au><au>Campos, Josemberg M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2015</date><risdate>2015</risdate><volume>25</volume><issue>1</issue><spage>72</spage><epage>79</epage><pages>72-79</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
The failure of approximately 20 % of obese patients who undergo Roux-en-Y gastric bypass (RYGB) to maintain weight loss over the following 18–24 months is related to the surgical procedure, to the patient, or both. Although the underlying mechanisms are uncertain, one factor that has been postulated is the dilation of the gastrojejunal anastomosis. The objective was to evaluate the safety and efficacy of the serial use of argon plasma coagulation (APC) in reducing the diameter of the dilated gastrojejunal anastomosis and post-RYGB weight regain.
Methods
We carried out a prospective, nonrandomized study of 30 patients, with no control or sham group, monitoring RYGB weight regain associated with dilation of the gastrojejunal anastomosis over a postoperative period of 18 months. Each patient underwent three sessions of APC in the anastomosis separated by 8 weeks, with a final endoscopic examination 8 weeks after the last session.
Results
There was a loss of 15.48 kg (range = 8.0–16.0 kg) of the 19.6 kg (range = 7.0–39.0 kg) of regained weight after RYGB and a reduction of 66.89 % in the final anastomotic diameter, with statistically significant reductions between each APC session. Previous body mass index significantly decreased up to the final examination, and the final weight was close to but not at the same level as the nadir.
Conclusions
Our study indicates that the use of APC to treat weight regain after RYGB is a safe and effective procedure and promotes a reduction in gastrojejunal anastomosis, final weight, and BMI, with a low rate of complications.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>25005812</pmid><doi>10.1007/s11695-014-1363-2</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Anastomosis, Roux-en-Y - adverse effects Anastomosis, Roux-en-Y - methods Argon Plasma Coagulation - adverse effects Argon Plasma Coagulation - methods Body Mass Index Dilatation, Pathologic - surgery Endoscopy - methods Female Gastric Bypass - adverse effects Gastric Bypass - methods Gastrointestinal surgery Humans Jejunum - surgery Male Medical procedures Medicine Medicine & Public Health Middle Aged Obesity Obesity, Morbid - surgery Original Contributions Reoperation - methods Surgery Treatment Failure Treatment Outcome Weight Weight Gain Young Adult |
| title | Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass |
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