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Five-year results of endoscopic gastrojejunostomy revision (transoral outlet reduction) for weight gain after gastric bypass.
Surgical Endoscopy ( IF 2.4 ) Pub Date : 2019-07-25 , DOI: 10.1007/s00464-019-07003-6
Zachary M Callahan 1 , Bailey Su 1 , Kristine Kuchta 1 , John Linn 1 , JoAnn Carbray 1 , Michael Ujiki 1
Affiliation  

BACKGROUND The study aim is to determine if patients who have undergone endoscopic gastrojejunostomy revision (EGJR) maintain weight loss up to 5 years postoperatively. METHODS This is a retrospective review of patients who underwent EGJR with a full-thickness endoscopic suturing device between April 2009 and June 2018. Percent of excess body weight loss (%EBWL) was calculated using the weight on day of EGJR consult as baseline. The paired t test and McNemar's test were used to compare weight and comorbidities between preoperative and postoperative time points. RESULTS A total of 70 patients regained a mean of 42.8 ± 18.7% of the weight lost after gastric bypass. On day of EGJR consult, average was 116.1 ± 25.2 kg and BMI of 42.3 ± 8.5. Weight loss and %EBWL at follow-up was as follows: 10.7 ± 11.6 kg and 18.5 ± 18.2% at 6 months, 8.5 ± 11.5 kg and 14.9 ± 20.6% at 1 year, 6.9 ± 10.7 kg and 12.2 ± 19.8% at 2 years, 5.3 ± 9.1 kg and 8.7 ± 14.9% at 3 years, 3.1 ± 12.0 kg and 3.2 ± 21.6% at 4 years, and 3.9 ± 13.1 kg and 7.0 ± 23.8% at 5 years. The percentage of patients with obstructive sleep apnea, hypertension, hyperlipidemia, and diabetes did not change over time. Patients who received a pursestring revision or had a greater percent reduction in stoma diameter had more significant %EBWL. CONCLUSIONS Weight loss after EGJR is sustained up to 5 years after revision with little effect on medical comorbidities. Patients with a greater reduction in stoma diameter experienced superior weight loss.

中文翻译:

胃旁路术后胃镜空肠吻合术修订(经口减少)的五年结果。

背景技术研究目的是确定接受内镜胃空肠吻合术(EGJR)手术的患者是否在术后5年内保持体重减轻。方法这是对2009年4月至2018年6月间使用全厚度内窥镜缝合设备进行EGJR的患者进行的回顾性回顾。使用EGJR当天的体重作为基准,计算出多余的体重减轻百分比(%EBWL)。配对t检验和McNemar检验用于比较术前和术后时间点之间的体重和合并症。结果总共有70例患者在胃旁路手术后平均恢复了体重减轻的42.8±18.7%。在EGJR咨询的当天,平均体重为116.1±25.2千克,BMI为42.3±8.5。随访时体重减轻和%EBWL如下:6个月时为10.7±11.6kg,18.5±18.2%,8.5±11。1年时5公斤和14.9±20.6%,2年时6.9±10.7公斤和12.2±19.8%,3年时5.3±9.1公斤和8.7±14.9%,4年时3.1±12.0公斤和3.2±21.6%,和5年时的3.9±13.1公斤和7.0±23.8%。阻塞性睡眠呼吸暂停,高血压,高脂血症和糖尿病患者的百分比未随时间变化。接受皮筋修补术或造口直径减小百分比更大的患者具有更大的%EBWL。结论EGJR术后的体重减轻持续至修订后5年,对合并症的影响很小。气孔直径减小较大的患者可减轻体重。5年时为8%。阻塞性睡眠呼吸暂停,高血压,高脂血症和糖尿病患者的百分比未随时间变化。接受皮筋修补术或造口直径减小百分比更大的患者具有更大的%EBWL。结论EGJR术后的体重减轻持续至修订后5年,对合并症的影响很小。气孔直径减小较大的患者可减轻体重。5年时为8%。阻塞性睡眠呼吸暂停,高血压,高脂血症和糖尿病患者的百分比未随时间变化。接受皮筋修补术或造口直径减小百分比更大的患者具有更大的%EBWL。结论EGJR术后的体重减轻持续至修订后5年,对合并症的影响很小。气孔直径减小较大的患者可减轻体重。
更新日期:2020-04-22
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