Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a “migration crisis”?
Roux-en-Y gastric bypass (RYGB) is the second most frequently performed bariatric procedure worldwide. While pouch migration is a common phenomenon after sleeve gastrectomy, it has hardly been documented after RYGB so far. The aim of this study was to correlate the diagnostic performance of gastrosc...
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| Veröffentlicht in: | Surgery for obesity and related diseases 2020-12, Vol.16 (12), p.1902-1908 |
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| creator | Arnoldner, Michael A. Felsenreich, Daniel M. Langer, Felix B. Weber, Michael Mang, Thomas Kulinna-Cosentini, Christiane Prager, Gerhard |
| description | Roux-en-Y gastric bypass (RYGB) is the second most frequently performed bariatric procedure worldwide. While pouch migration is a common phenomenon after sleeve gastrectomy, it has hardly been documented after RYGB so far.
The aim of this study was to correlate the diagnostic performance of gastroscopy of the gastroesophageal junction with 3-dimensional computed tomography (CT) during postoperative care of patients revised due to weight regain after RYGB, with particular attention to intrathoracic pouch migration (ITM) and pouch volume.
University Hospital Setting, Austria.
Thirty RYGB patients that were revised owing to weight regain (median age 37.5 yr) before December 2017 were included in this prospective study. CT findings were correlated with gastroscopy regarding pouch size and ITM. Pouch distention was achieved with both oral contrast and effervescent granules. All patients had CT and gastroscopy on the same day. In addition, patients were evaluated for reflux disease based on clinical history.
ITM was found in 20 of 30 (66.7%) patients in CT, whereas gastroscopy did not correctly identify any herniation. In 16 of 28 (57.1%) patients pouch measurements at gastroscopy and CT showed a difference |
| doi_str_mv | 10.1016/j.soard.2020.07.024 |
| format | Article |
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The aim of this study was to correlate the diagnostic performance of gastroscopy of the gastroesophageal junction with 3-dimensional computed tomography (CT) during postoperative care of patients revised due to weight regain after RYGB, with particular attention to intrathoracic pouch migration (ITM) and pouch volume.
University Hospital Setting, Austria.
Thirty RYGB patients that were revised owing to weight regain (median age 37.5 yr) before December 2017 were included in this prospective study. CT findings were correlated with gastroscopy regarding pouch size and ITM. Pouch distention was achieved with both oral contrast and effervescent granules. All patients had CT and gastroscopy on the same day. In addition, patients were evaluated for reflux disease based on clinical history.
ITM was found in 20 of 30 (66.7%) patients in CT, whereas gastroscopy did not correctly identify any herniation. In 16 of 28 (57.1%) patients pouch measurements at gastroscopy and CT showed a difference <40%. In 2 patients, pouch distention was not sufficient for CT volumetry. The intraclass correlation coefficient proved to be .594. Symptomatic reflux was present in 10 of 30 (33.3%) patients, 5 of whom had ITM.
ITM is an underreported finding after revised RYGB and missed in gastroscopy. In terms of pouch volume, 3-dimensional–CT volumetry demonstrated only moderate agreement with gastroscopy.</description><identifier>ISSN: 1550-7289</identifier><identifier>EISSN: 1878-7533</identifier><identifier>DOI: 10.1016/j.soard.2020.07.024</identifier><identifier>PMID: 32917519</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>3 D-CT pouch volumetry ; Adult ; Gastric Bypass - adverse effects ; Gastroscopy ; Humans ; Intrathoracic pouch migration ; Obesity, Morbid - surgery ; Pouch volume ; Prospective Studies ; Reflux ; Reoperation ; Roux-en-Y gastric bypass ; Tomography, X-Ray Computed</subject><ispartof>Surgery for obesity and related diseases, 2020-12, Vol.16 (12), p.1902-1908</ispartof><rights>2020 American Society for Bariatric Surgery</rights><rights>Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-269654df64d6d6111704b67ccc52c8bcbcbcb85ceb00842dd11026cc28fc71873</citedby><cites>FETCH-LOGICAL-c359t-269654df64d6d6111704b67ccc52c8bcbcbcb85ceb00842dd11026cc28fc71873</cites><orcidid>0000-0002-8507-2219 ; 0000-0002-5229-5096</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1550728920304275$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32917519$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arnoldner, Michael A.</creatorcontrib><creatorcontrib>Felsenreich, Daniel M.</creatorcontrib><creatorcontrib>Langer, Felix B.</creatorcontrib><creatorcontrib>Weber, Michael</creatorcontrib><creatorcontrib>Mang, Thomas</creatorcontrib><creatorcontrib>Kulinna-Cosentini, Christiane</creatorcontrib><creatorcontrib>Prager, Gerhard</creatorcontrib><title>Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a “migration crisis”?</title><title>Surgery for obesity and related diseases</title><addtitle>Surg Obes Relat Dis</addtitle><description>Roux-en-Y gastric bypass (RYGB) is the second most frequently performed bariatric procedure worldwide. While pouch migration is a common phenomenon after sleeve gastrectomy, it has hardly been documented after RYGB so far.
The aim of this study was to correlate the diagnostic performance of gastroscopy of the gastroesophageal junction with 3-dimensional computed tomography (CT) during postoperative care of patients revised due to weight regain after RYGB, with particular attention to intrathoracic pouch migration (ITM) and pouch volume.
University Hospital Setting, Austria.
Thirty RYGB patients that were revised owing to weight regain (median age 37.5 yr) before December 2017 were included in this prospective study. CT findings were correlated with gastroscopy regarding pouch size and ITM. Pouch distention was achieved with both oral contrast and effervescent granules. All patients had CT and gastroscopy on the same day. In addition, patients were evaluated for reflux disease based on clinical history.
ITM was found in 20 of 30 (66.7%) patients in CT, whereas gastroscopy did not correctly identify any herniation. In 16 of 28 (57.1%) patients pouch measurements at gastroscopy and CT showed a difference <40%. In 2 patients, pouch distention was not sufficient for CT volumetry. The intraclass correlation coefficient proved to be .594. Symptomatic reflux was present in 10 of 30 (33.3%) patients, 5 of whom had ITM.
ITM is an underreported finding after revised RYGB and missed in gastroscopy. In terms of pouch volume, 3-dimensional–CT volumetry demonstrated only moderate agreement with gastroscopy.</description><subject>3 D-CT pouch volumetry</subject><subject>Adult</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastroscopy</subject><subject>Humans</subject><subject>Intrathoracic pouch migration</subject><subject>Obesity, Morbid - surgery</subject><subject>Pouch volume</subject><subject>Prospective Studies</subject><subject>Reflux</subject><subject>Reoperation</subject><subject>Roux-en-Y gastric bypass</subject><subject>Tomography, X-Ray Computed</subject><issn>1550-7289</issn><issn>1878-7533</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1q3DAUhUVoSdK0TxAIWnZjV5KtHwdKCNNfCDSEdNGVkK_kRMPYciQ7dHZ5ie7al8uTVJmZtruixRW6557D1YfQMSUlJVS8WZYpmGhLRhgpiSwJq_fQIVVSFZJX1bN855wUkqnmAL1IaUlIJbhk--igYg2VnDaH6MdlmOEW34fV3DtsBovHzUPvb6KZfBiw6SYX8VWYvxduKL7hG5Om6AG369GkdIoNhtCPJvqUxaHb9kOCMK43fhV-VyyudwlTXJ9in_B062KOw48PP_8lQfbw6fHh19lL9Lwzq-Re7eoR-vrh_fXiU3Hx5ePnxflFARVvpoKJRvDadqK2wgpKqSR1KyQAcAaqhc1RHFxLiKqZtZQSJgCY6kDmj6qO0Out7xjD3ezSpHufwK1WZnBhTprVNWNUNarO0morhbxciq7TY_S9iWtNiX7ioZd6w0M_8dBE6swjT53sAua2d_bvzB8AWfB2K3B5zXvvok7g3QDO-uhg0jb4_wb8BuLIoI0</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Arnoldner, Michael A.</creator><creator>Felsenreich, Daniel M.</creator><creator>Langer, Felix B.</creator><creator>Weber, Michael</creator><creator>Mang, Thomas</creator><creator>Kulinna-Cosentini, Christiane</creator><creator>Prager, Gerhard</creator><general>Elsevier Inc</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>7X8</scope><orcidid>https://orcid.org/0000-0002-8507-2219</orcidid><orcidid>https://orcid.org/0000-0002-5229-5096</orcidid></search><sort><creationdate>202012</creationdate><title>Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a “migration crisis”?</title><author>Arnoldner, Michael A. ; Felsenreich, Daniel M. ; Langer, Felix B. ; Weber, Michael ; Mang, Thomas ; Kulinna-Cosentini, Christiane ; Prager, Gerhard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-269654df64d6d6111704b67ccc52c8bcbcbcb85ceb00842dd11026cc28fc71873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>3 D-CT pouch volumetry</topic><topic>Adult</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastroscopy</topic><topic>Humans</topic><topic>Intrathoracic pouch migration</topic><topic>Obesity, Morbid - surgery</topic><topic>Pouch volume</topic><topic>Prospective Studies</topic><topic>Reflux</topic><topic>Reoperation</topic><topic>Roux-en-Y gastric bypass</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arnoldner, Michael A.</creatorcontrib><creatorcontrib>Felsenreich, Daniel M.</creatorcontrib><creatorcontrib>Langer, Felix B.</creatorcontrib><creatorcontrib>Weber, Michael</creatorcontrib><creatorcontrib>Mang, Thomas</creatorcontrib><creatorcontrib>Kulinna-Cosentini, Christiane</creatorcontrib><creatorcontrib>Prager, Gerhard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery for obesity and related diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arnoldner, Michael A.</au><au>Felsenreich, Daniel M.</au><au>Langer, Felix B.</au><au>Weber, Michael</au><au>Mang, Thomas</au><au>Kulinna-Cosentini, Christiane</au><au>Prager, Gerhard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a “migration crisis”?</atitle><jtitle>Surgery for obesity and related diseases</jtitle><addtitle>Surg Obes Relat Dis</addtitle><date>2020-12</date><risdate>2020</risdate><volume>16</volume><issue>12</issue><spage>1902</spage><epage>1908</epage><pages>1902-1908</pages><issn>1550-7289</issn><eissn>1878-7533</eissn><abstract>Roux-en-Y gastric bypass (RYGB) is the second most frequently performed bariatric procedure worldwide. While pouch migration is a common phenomenon after sleeve gastrectomy, it has hardly been documented after RYGB so far.
The aim of this study was to correlate the diagnostic performance of gastroscopy of the gastroesophageal junction with 3-dimensional computed tomography (CT) during postoperative care of patients revised due to weight regain after RYGB, with particular attention to intrathoracic pouch migration (ITM) and pouch volume.
University Hospital Setting, Austria.
Thirty RYGB patients that were revised owing to weight regain (median age 37.5 yr) before December 2017 were included in this prospective study. CT findings were correlated with gastroscopy regarding pouch size and ITM. Pouch distention was achieved with both oral contrast and effervescent granules. All patients had CT and gastroscopy on the same day. In addition, patients were evaluated for reflux disease based on clinical history.
ITM was found in 20 of 30 (66.7%) patients in CT, whereas gastroscopy did not correctly identify any herniation. In 16 of 28 (57.1%) patients pouch measurements at gastroscopy and CT showed a difference <40%. In 2 patients, pouch distention was not sufficient for CT volumetry. The intraclass correlation coefficient proved to be .594. Symptomatic reflux was present in 10 of 30 (33.3%) patients, 5 of whom had ITM.
ITM is an underreported finding after revised RYGB and missed in gastroscopy. In terms of pouch volume, 3-dimensional–CT volumetry demonstrated only moderate agreement with gastroscopy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32917519</pmid><doi>10.1016/j.soard.2020.07.024</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8507-2219</orcidid><orcidid>https://orcid.org/0000-0002-5229-5096</orcidid></addata></record> |
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| identifier | ISSN: 1550-7289 |
| ispartof | Surgery for obesity and related diseases, 2020-12, Vol.16 (12), p.1902-1908 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | 3 D-CT pouch volumetry Adult Gastric Bypass - adverse effects Gastroscopy Humans Intrathoracic pouch migration Obesity, Morbid - surgery Pouch volume Prospective Studies Reflux Reoperation Roux-en-Y gastric bypass Tomography, X-Ray Computed |
| title | Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a “migration crisis”? |
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