Evidence map›Paper›PMID 30701363›Full record

ArticleSurgical endoscopy2019

Long-term outcomes following endoscopic stenting in the management of leaks after foregut and bariatric surgery.

Varun Krishnan, Kevin Hutchings, Andrew Godwin, Jonathan T Wong, Julio Teixeira

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 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

8 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
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

5 authors.

Varun KrishnanDepartment of Surgery, Northwell Health, Achelis Hall 8th Floor 100 E. 77th St, 10075, New York, NY, USA. vkrishnan2@northwell.edu.ORCID 0000-0001-8961-6810
Kevin HutchingsDepartment of Surgery, Northwell Health, Achelis Hall 8th Floor 100 E. 77th St, 10075, New York, NY, USA.
Andrew GodwinDepartment of Surgery, Northwell Health, Achelis Hall 8th Floor 100 E. 77th St, 10075, New York, NY, USA.
Jonathan T WongDepartment of Surgery, Northwell Health, Achelis Hall 8th Floor 100 E. 77th St, 10075, New York, NY, USA.
Julio TeixeiraDepartment of Surgery, Northwell Health, Achelis Hall 8th Floor 100 E. 77th St, 10075, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEndoscopic stenting has been shown to be effective in treating leaks after bariatric surgery. However, concerns remain regarding its long-term efficacy. The purpose of this study was to assess the evolution of endoscopic stenting and its efficacy over time, as well as the impact of stent fixation on migration rates and long-term outcomes. In addition, the effect of stenting on long-term weight loss and chronic reflux was also evaluated.

methodsA retrospective review was conducted including 37 patients from 2005 to 2017 who had undergone placement of stents after various bariatric procedures. Stents were placed endoscopically and, after 2012, secured with a figure-of-eight overstitch. Demographics, weight loss data, stent migration rates, incidence of revision surgery, chronic PPI use, and chronic symptoms of reflux data were obtained and analyzed.

resultsThirty-seven patients from 2005 to 2017 required endoscopic stenting for leaks. 43.24% patients underwent sleeve gastrectomy, 40.54% gastric bypass, 5.40% patients underwent duodenal switch, and 10.81% underwent miscellaneous foregut procedures. The overall success rate was 94.59% (35 of 37 patients). The incidence of stent migration before 2012 was 41.18% versus 15% after 2012 (p = 0.136271). There were 2 treatment failures, one treated successfully with re-stenting and another other requiring revision surgery. Overall, the percent of excess body weight lost was 57.21% over an average of 21 months. 58.82% of patients used PPI chronically; however 41.17% noted actual symptoms of reflux. 16.22% (6 of 37) patients ultimately underwent revision surgery.

conclusionEndoscopic stenting is a safe and effective treatment for leaks after bariatric surgery. While complications can include stent migration, newer stent technology and endoscopic overstitching techniques show promise in reducing the incidence of stent migration. Despite undergoing treatment with stenting, these patients had successful weight loss with relatively low rates of chronic PPI use and reflux symptoms.

Indexed as

StentsAbdomenAdultAnastomotic LeakBariatric SurgeryEndoscopyFemaleGastrectomyGastric BypassHumansMaleObesity, MorbidPostoperative ComplicationsReoperationRetrospective StudiesTreatment OutcomeEndoscopic stentingLeaks after bariatric surgeryRevision bariatric surgery

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.