Evidence map›Paper›PMID 24721521›Full record

ArticleGastrointestinal endoscopy2014

Comparison of a superficial suturing device with a full-thickness suturing device for transoral outlet reduction (with videos).

Nitin Kumar, Christopher C Thompson

Abstract readComparative StudyVideo-Audio Media
PubMed Full text at PMC Publisher
In one paragraph

Article in Gastrointestinal endoscopy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Review
  7. Article
  8. Review
  9. Review
  10. Article
  11. Article
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  13. Article
  14. Article
  15. Endoscopic Treatments Following Bariatric Surgery.Gastrointestinal endoscopy clinics of North America · 2017
    Review
  16. Article
  17. Article
  18. [Conversional and endoscopic procedures following bariatric surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2016
    Review
  19. Review
  20. Endoscopic Devices for Obesity.Current obesity reports · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Nitin KumarDivision of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts.
Christopher C ThompsonDivision of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts.

Funding

STRUCTURE-FUNCTION RELATIONSHIPS IN THE ALIMENTARY TRACTP30DK034854 · NIDDK · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI JONATHAN C KAGAN · 1986 to 2026
$32.4M
ALIMENTARY TRACT RESEARCH IN HEALTH AND DISEASET32DK007533 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI BLUMBERG, RICHARD S · 1986 to 2020
$5.3M
NIDDK NIH HHS P30 DK034854NIDDK NIH HHS T32 DK007533
6 · The paper itself

Abstract

backgroundLarger gastrojejunal (GJ) anastomosis aperture is one independent predictor for weight regain after Roux-en-Y gastric bypass. Transoral outlet reduction (TORe) has proven safe and effective for treatment of weight regain by using a superficial-thickness (ST) suturing device. Full-thickness (FT) suturing devices are now available, potentially providing more effective results.

objectiveTo compare effectiveness of superficial-thickness with full-thickness TORe.

designMatched cohort study: patients were matched sequentially by GJ anastomosis aperture, body mass index, and age.

settingTertiary-care center. PATIENTS: A total of 59 consecutive patients undergoing full-thickness TORe were matched with 59 patients undergoing superficial-thickness TORe. All had GJ anastomosis apertures >20 mm.

interventionTransoral outlet reduction. MAIN OUTCOME MEASUREMENTS: Weight loss and rate of adverse events.

resultsPost-TORe GJ anastomosis apertures were similar between groups (ST 6.9 ± 0.2 mm vs FT 7.1 ± 0.3 mm). Weight loss was greater at 6 months in the FT group (10.6 ± 1.8 kg in FT vs 4.4 ± 0.8 kg in ST; P < .01) and at 1 year (8.6 ± 2.5 kg in FT vs 2.9 ± 1.0 kg in ST; P < .01). Excess weight loss was greater in the FT group at 6 months (20.4 ± 3.3% in FT vs 8.1 ± 2.5% in ST; P < .01) and at 1 year (18.9 ± 5.4% in FT vs 9.1 ± 2.3% in ST; P = .03). LIMITATIONS: This was a single-center, retrospective, cohort study.

conclusionThere is level 1b evidence for effectiveness of TORe by using a superficial mucosal suturing device. This matched cohort study compared TORe by using the same ST suturing device with TORe by using a newer, FT suturing device and the same operative methods. FT TORe resulted in significantly more weight loss than ST TORe at 6 months and at 1 year. Full-thickness TORe is a significant improvement over ST TORe for endoscopic therapy of weight regain in patients with dilated GJ anastomosis.

Indexed as

Body Mass IndexEquipment DesignFemaleFollow-Up StudiesGastric BypassHumansMaleMiddle AgedMouthNatural Orifice Endoscopic SurgeryObesity, MorbidRetrospective StudiesStomachSuture TechniquesTreatment Outcome

Identifiers

PMID24721521
PMCPMC5038592

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.