PMID- 35259393
OWN - NLM
STAT- MEDLINE
DCOM- 20220621
LR  - 20230703
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 96
IP  - 1
DP  - 2022 Jul
TI  - Endoscopic gastric plication for the treatment of weight regain after Roux-en-Y 
      gastric bypass (with video).
PG  - 51-56
LID - S0016-5107(22)00190-0 [pii]
LID - 10.1016/j.gie.2022.02.051 [doi]
AB  - BACKGROUND AND AIMS: Gastric plication involves inverting the stomach with tissue 
      anchor placement to achieve serosa-to-serosa apposition. One potential 
      application of gastric plication is the treatment of weight regain after 
      Roux-en-Y gastric bypass (RYGB), a procedure also known as plication transoral 
      outlet reduction (P-TORe). This study aims to assess technical feasibility, 
      safety, and efficacy of P-TORe. METHODS: This was a registry study of RYGB 
      patients who underwent P-TORe for weight regain. The primary outcome was the 
      amount of weight loss and clinical success rate, defined as percentage of total 
      weight loss (TWL) of at least 5% at 12 months. Secondary outcomes were technical 
      success, adverse events (AEs), and predictors of weight loss. RESULTS: One 
      hundred eleven RYGB patients underwent P-TORe. Average body mass index (BMI) was 
      38.5 +/- 7.5 kg/m(2). Baseline gastrojejunal anastomosis (GJA) and pouch sizes were 
      17 +/- 6 mm and 5 +/- 2 cm, respectively. The primary outcome was total weight loss, 
      defined as patients experiencing 9.5% +/- 8.5% TWL at 12 months. Clinical success 
      rate was 73%. Technical success rate was 100%. Argon plasma coagulation (APC) was 
      performed around the GJA in all patients (100%) before plication placement. The 
      total number of plications per case was 7 +/- 3. Overall AE rate was 12.6%. These 
      included GJA stenosis (9.9%), melena because of marginal ulceration (1.8%), and 
      deep vein thrombosis (.9%). The severe AE rate was 0%. Predictors of weight loss 
      were the amount of weight regain and baseline pouch length. CONCLUSIONS: This 
      novel P-TORe technique combining APC with gastric plication appears to be 
      technically feasible, safe, and effective at treating weight regain after RYGB.
CI  - Copyright (c) 2022 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, USA; Harvard Medical School, Boston, 
      Massachusetts, USA.
FAU - Thompson, Christopher C
AU  - Thompson CC
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Boston, Massachusetts, USA; 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
PT  - Video-Audio Media
DEP - 20220305
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Anastomosis, Roux-en-Y
MH  - *Gastric Bypass/adverse effects
MH  - Humans
MH  - *Obesity, Morbid/surgery
MH  - Reoperation/methods
MH  - Retrospective Studies
MH  - Stomach/surgery
MH  - Treatment Outcome
MH  - Weight Gain
MH  - Weight Loss
PMC - PMC9233122
MID - NIHMS1809312
EDAT- 2022/03/09 06:00
MHDA- 2022/06/22 06:00
PMCR- 2023/07/01
CRDT- 2022/03/08 20:10
PHST- 2021/10/22 00:00 [received]
PHST- 2022/02/15 00:00 [accepted]
PHST- 2022/03/09 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
PHST- 2022/03/08 20:10 [entrez]
PHST- 2023/07/01 00:00 [pmc-release]
AID - S0016-5107(22)00190-0 [pii]
AID - 10.1016/j.gie.2022.02.051 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2022 Jul;96(1):51-56. doi: 10.1016/j.gie.2022.02.051. Epub 
      2022 Mar 5.