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Dose response for argon plasma coagulation in the treatment of weight regain after Roux-en-Y gastric bypass.
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2020-01-03 , DOI: 10.1016/j.gie.2019.12.036 Pichamol Jirapinyo 1 , Diogo T H de Moura 2 , William Y Dong 3 , Galileu Farias 4 , Christopher C Thompson 1
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2020-01-03 , DOI: 10.1016/j.gie.2019.12.036 Pichamol Jirapinyo 1 , Diogo T H de Moura 2 , William Y Dong 3 , Galileu Farias 4 , Christopher C Thompson 1
Affiliation
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.
中文翻译：
Roux-en-Y胃绕道手术后体重恢复中氩气血浆凝结的剂量反应。
背景与目的胃空肠吻合术（GJA）的氩血浆凝固（APC）可有效治疗Roux-en-Y胃搭桥术（RYGB）后的体重恢复。这项研究旨在比较不同APC设置治疗体重增加的功效。方法这是一项单中心回顾性研究，研究对象是RYGB，然后于2014年至2018年接受APC减肥的患者。比较仅接受小剂量APC（45-55 W）或大剂量APC（70-80 W）的患者。主要结局是最后一次治疗后6个月和12个月时两组之间的总体重减轻百分比（％TWL）的差异。次要结果是技术成功，不良事件（AE）和12个月时体重减轻的预测指标。结果217例患者符合入选标准，接受了411次APC治疗。这些，116名（53.5％）患者接受了267次低剂量APC疗程（2.4±1.5疗程/每位患者）和101（46.5％）患者接受了144次大剂量APC疗程（1.4±0.7疗程/每位患者）6个月和12个月的随访率分别为82.9％和75.3％。在6个月时，低剂量和高剂量组的TWL分别为7.3％±6.6％和8.1％±7.4％（P = .41）。在12个月时，低剂量和高剂量组的TWL分别为5.1％±8.5％和9.7％±10.0％（P = .008）。技术成功率为100％。总AE率为8.0％；最常见的AE是GJA狭窄（4.6％）。低剂量和高剂量组的GJA狭窄率相似（3.0％比7.6％，P = .06）。控制混杂因素后，大剂量APC仍是1年体重减轻更大的重要预测指标。结论APC可有效治疗RYGB后的体重恢复，
更新日期：2020-01-03
中文翻译：
Roux-en-Y胃绕道手术后体重恢复中氩气血浆凝结的剂量反应。
背景与目的胃空肠吻合术（GJA）的氩血浆凝固（APC）可有效治疗Roux-en-Y胃搭桥术（RYGB）后的体重恢复。这项研究旨在比较不同APC设置治疗体重增加的功效。方法这是一项单中心回顾性研究，研究对象是RYGB，然后于2014年至2018年接受APC减肥的患者。比较仅接受小剂量APC（45-55 W）或大剂量APC（70-80 W）的患者。主要结局是最后一次治疗后6个月和12个月时两组之间的总体重减轻百分比（％TWL）的差异。次要结果是技术成功，不良事件（AE）和12个月时体重减轻的预测指标。结果217例患者符合入选标准，接受了411次APC治疗。这些，116名（53.5％）患者接受了267次低剂量APC疗程（2.4±1.5疗程/每位患者）和101（46.5％）患者接受了144次大剂量APC疗程（1.4±0.7疗程/每位患者）6个月和12个月的随访率分别为82.9％和75.3％。在6个月时，低剂量和高剂量组的TWL分别为7.3％±6.6％和8.1％±7.4％（P = .41）。在12个月时，低剂量和高剂量组的TWL分别为5.1％±8.5％和9.7％±10.0％（P = .008）。技术成功率为100％。总AE率为8.0％；最常见的AE是GJA狭窄（4.6％）。低剂量和高剂量组的GJA狭窄率相似（3.0％比7.6％，P = .06）。控制混杂因素后，大剂量APC仍是1年体重减轻更大的重要预测指标。结论APC可有效治疗RYGB后的体重恢复，
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