PMID- 31904378
OWN - NLM
STAT- MEDLINE
DCOM- 20210217
LR  - 20210502
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 91
IP  - 5
DP  - 2020 May
TI  - Dose response for argon plasma coagulation in the treatment of weight regain 
      after Roux-en-Y gastric bypass.
PG  - 1078-1084
LID - S0016-5107(19)32578-7 [pii]
LID - 10.1016/j.gie.2019.12.036 [doi]
AB  - BACKGROUND AND AIMS: Argon plasma coagulation (APC) of gastrojejunal anastomosis 
      (GJA) is effective in treating weight regain after Roux-en-Y gastric bypass 
      (RYGB). This study aims to compare the efficacy of different APC settings for 
      treating weight regain. METHODS: This was a single-center retrospective study of 
      patients who had undergone RYGB and then underwent APC from 2014 to 2018 for 
      weight regain. Patients receiving only low-dose APC (45-55 W) or high-dose APC 
      (70-80 W) were compared. The primary outcome was the difference in percentage 
      total weight loss (% TWL) between the groups at 6 and 12 months after the last 
      treatment. Secondary outcomes were technical success, adverse events (AEs), and 
      predictors of weight loss at 12 months. RESULTS: Two hundred seventeen patients 
      met the inclusion criteria and underwent 411 APC sessions. Of these, 116 (53.5%) 
      patients underwent 267 low-dose APC sessions (2.4 +/- 1.5 sessions/patient) and 101 
      (46.5%) patients underwent 144 high-dose APC sessions (1.4 +/- 0.7 
      sessions/patient). Follow-up rates were 82.9% and 75.3% at 6 and 12 months. At 6 
      months, the low- and high-dose groups experienced 7.3% +/- 6.6% and 8.1% +/- 7.4% 
      TWL, respectively (P = .41). At 12 months, the low- and high-dose groups 
      experienced 5.1% +/- 8.5% and 9.7% +/- 10.0% TWL, respectively (P = .008). Technical 
      success was 100%. The overall AE rate was 8.0%; the most common AE was GJA 
      stenosis (4.6%). The GJA stenosis rate was similar for the low- and high-dose 
      groups (3.0% vs 7.6%, P = .06). High-dose APC remained a significant predictor of 
      greater weight loss at 1 year after controlling for confounders. CONCLUSION: APC 
      is effective at treating weight regain after RYGB, and higher-watt APC was 
      associated with greater weight loss.
CI  - Copyright (c) 2020 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Jirapinyo, Pichamol
AU  - Jirapinyo P
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts, 
      USA.
FAU - de Moura, Diogo T H
AU  - de Moura DTH
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts, 
      USA; Gastroenterology Department, Hospital das Clinicas da Faculdade de Medicina 
      da Universidade de Sao Paulo, Sao Paulo, Brazil.
FAU - Dong, William Y
AU  - Dong WY
AD  - Stony Brook University, Stony Brook, New York, USA.
FAU - Farias, Galileu
AU  - Farias G
AD  - Gastroenterology Department, Hospital das Clinicas da Faculdade de Medicina da 
      Universidade de Sao Paulo, Sao Paulo, Brazil.
FAU - Thompson, Christopher C
AU  - Thompson CC
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts, 
      USA.
LA  - eng
GR  - P30 DK034854/DK/NIDDK NIH HHS/United States
GR  - T32 DK007533/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20200103
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2020 Aug;92(2):455-456. PMID: 32703373
MH  - Adult
MH  - Argon Plasma Coagulation
MH  - Female
MH  - *Gastric Bypass
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/surgery
MH  - Reoperation
MH  - Retrospective Studies
MH  - Weight Gain
PMC - PMC7183414
MID - NIHMS1548063
COIS- Conflict of Interests: P.J. has received research support from Apollo 
      Endosurgery, Fractyl and GI Dynamics, and has served as a consultant to 
      Endogastric Solutions and GI Dynamics. D.D., W.D. and G.F. have no conflict of 
      interest. C.C.T. has served as a consultant for Boston Scientific, Apollo 
      Endosurgery,, Fractyl, USGI Medical, Medtronic/Covidien, Olympus/Spiration and GI 
      Dynamics, has served as an advisory boards member for USGI Medical and Fractyl, 
      has received research grant and support from USGI Medical, Apollo Endosurgery, 
      Olympus/Spiratio, Aspire Bariatrics and Spatz and GI Dynamics, has served as a 
      general partners for Blueframe Healthcare, and holds stock and royalties for GI 
      Windows.
EDAT- 2020/01/07 06:00
MHDA- 2021/02/18 06:00
PMCR- 2021/05/01
CRDT- 2020/01/07 06:00
PHST- 2019/08/17 00:00 [received]
PHST- 2019/12/15 00:00 [accepted]
PHST- 2020/01/07 06:00 [pubmed]
PHST- 2021/02/18 06:00 [medline]
PHST- 2020/01/07 06:00 [entrez]
PHST- 2021/05/01 00:00 [pmc-release]
AID - S0016-5107(19)32578-7 [pii]
AID - 10.1016/j.gie.2019.12.036 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2020 May;91(5):1078-1084. doi: 10.1016/j.gie.2019.12.036. 
      Epub 2020 Jan 3.