We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Endoscopic Argon Plasma Coagulation vs. Multidisciplinary Evaluation in the Management of Weight Regain After Gastric Bypass Surgery: a Randomized Controlled Trial with SHAM Group.
- Authors
de Quadros, Luiz Gustavo; Neto, Manoel Galvão; Marchesini, João Caetano; Teixeira, André; Grecco, Eduardo; Junior, Roberto Luiz Kaiser; Zundel, Natan; Filho, Idiberto José Zotarelli; de Souza, Thiago Ferreira; Filho, Admar Concon; da Silva, Lyz Bezerra; Ramos, Almino Cardoso; Ferraz, Álvaro Antônio Bandeira; Campos, Josemberg Marins
- Abstract
Background: Roux-en-Y gastric bypass is one of the most widely performed bariatric surgeries. However, the relapse of obesity occurs in approximately 20% of patients and enlargement of the anastomosis is one of the factors associated with this relapse. Endoscopic treatment of the anastomosis has been proposed to assist in renewed weight loss. One endoscopic technique is the narrowing of the anastomosis argon plasma coagulation (APC). Objective: Evaluate the effectiveness and safety of the endoscopic treatment of an enlarged anastomosis with APC. Methods: A randomized controlled study was conducted comparing APC to exclusive multidisciplinary management after weight regain. Results: Forty-two patients were divided into two groups: APC (n = 22) and control (n = 20). After 14 months of follow-up with a crossover at 6 months, significant improvement in satiety and greater weight loss were found in the APC group and after crossover. APC was associated with significant weight loss [9.73 (7.46, 12) vs. + 1.38 (− 1.39, 2.15)], a reduction in the anastomosis diameter [p < 0.001], early satiation [0.77 (0.44, 1.11) vs. − 0.59 (− 0.95, − 0.23), p < 0.001], and increased quality of life measured using the EQ5D index [p = 0.04] and EQ5D VAS scale [p = 0.04]. Considering total mean weight loss throughout the entire follow-up, weight loss was similar in both groups (13.02 kg in the APC and 11.52 kg in the control). Conclusion: Treatment of the gastrojejunal anastomosis with APC was effective and safe, with significant weight loss, the return of early satiation, and an improvement in quality of life.
- Subjects
GASTRIC bypass; ARGON plasmas; REGULATION of body weight; RANDOMIZED controlled trials; WEIGHT loss; COAGULATION
- Publication
Obesity Surgery, 2020, Vol 30, Issue 5, p1904
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-020-04414-6