ArticleSurgical endoscopy2018
Endoscopic gastrojejunostomy revision is more effective than medical management alone to address weight regain after RYGB.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis.Updates in surgery · 2021Pooled it
- Comparable improvement and resolution of obesity-related comorbidities in endoscopic sleeve gastroplasty vs laparoscopic sleeve gastrectomy: single-center study.Surgical endoscopy · 2024Article
- Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study.Obesity surgery · 2021Article
- Five-year results of endoscopic gastrojejunostomy revision (transoral outlet reduction) for weight gain after gastric bypass.Surgical endoscopy · 2020Article
- Modified-ESD Plus APC and Suturing for Treatment of Weight Regain After Gastric Bypass.Obesity surgery · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWeight regain after bariatric roux-en-y gastric bypass affects up to 30% of individuals. Revisional surgery is risky, and is typically avoided in favor of dietary and psychological management. Endoscopic gastrojejunostomy revision is a low-morbidity, outpatient procedure that may be more effective than medical management alone for regain after gastric bypass.
methodsTwo patient cohorts were retrospectively assembled. Both groups had gastric bypass, regained weight, and were cleared for revision by their surgeon, dietician, and psychologist. The revision group underwent the procedure, and the no-revision group did not, typically due to insurance issues. Weights from pre-bypass to 2 years post-revision, obesity-related comorbidities, and intraoperative factors were collected and analyzed.
resultsThere were 41 patients included in the revision group and 14 in the no-revision group. Up to the time of revision procedure, body mass index, and % excess weight loss between groups were similar. After revision, the groups diverged over a 2-year period, with improvement seen in the revision group and worsening in the no-revision group. The revision group showed overall improvement in comorbidities compared to the no-revision group. Analysis of intraoperative factors suggests that gastric pouch restriction in addition to stoma diameter reduction may promote weight loss.
conclusionsIn this retrospective study, endoscopic revision provided significantly greater weight loss compared to medical management alone. Results show that revision can help resolve obesity-related comorbidities. Analysis of intraoperative factors suggests that pouch reduction at time of stoma revision may improve weight loss.
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Registered trials
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.