Evidence map›Paper›PMID 38914888›Full record

ArticleSurgical endoscopy2024

Long-term results after transoral outlet reduction (TORe) of the gastrojejunal anastomosis for secondary weight regain and dumping syndrome after Roux-en-Y gastric bypass.

Jonathan Lovis, Stefan Fischli, Francesco Mongelli, Julia Mühlhäusser, Patrick Aepli, Martin Sykora, Andreas Scheiwiller, Jürg Metzger, Jörn-Markus Gass

Abstract read
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Transoral outlet reduction zipper technique for enhanced tissue approximation and potential improved durability.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026
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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

9 authors.

Jonathan Lovis *Department of General Surgery, Cantonal Hospital of Lucerne, Spitalstrasse , 6000, Lucerne 16, Switzerland.ORCID 0009-0000-3142-8518
Stefan Fischli *Department of Endocrinology, Cantonal Hospital of Lucerne, Spitalstrasse, 6000, Lucerne 16, Switzerland.
Francesco MongelliDepartment of Surgery, Regional Hospital of Lugano, Via Tesserete 46, 6900, Lugano, Switzerland.
Julia MühlhäusserDepartment of General Surgery, Cantonal Hospital of Lucerne, Spitalstrasse , 6000, Lucerne 16, Switzerland.
Patrick AepliDepartment of Gastroenterology, Cantonal Hospital of Lucerne, Spitalstrasse , 6000, Lucerne 16, Switzerland.
Martin SykoraDepartment of General Surgery, Cantonal Hospital of Nidwalden, Ennetmooserstrasse 19, 6370, Stans, Switzerland.
Andreas ScheiwillerDepartment of General Surgery, Cantonal Hospital of Lucerne, Spitalstrasse , 6000, Lucerne 16, Switzerland.
Jürg MetzgerDepartment of General Surgery, Cantonal Hospital of Lucerne, Spitalstrasse , 6000, Lucerne 16, Switzerland.
Jörn-Markus GassDepartment of General Surgery, Cantonal Hospital of Lucerne, Spitalstrasse , 6000, Lucerne 16, Switzerland. markusgass@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBariatric surgery has been proven to be the most effective therapy for obesity and Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed procedure. However, weight regain and dumping syndrome occur over time. The transoral outlet reduction (TORe) procedure using an endoscopic suturing device may be an option to treat these conditions. We aimed to analyze outcome parameters and long-term results for this endoscopic technique.

methodsA retrospective data analysis of patients who underwent TORe using an endoscopic suturing system at our institution from January 2015 to December 2020 was performed. A total of 71 subjects were included. Forty-five patients received the intervention for weight regain, 9 for dumping syndrome and 17 for both. The primary endpoint was weight stabilization or weight loss for subjects with weight regain, and resolution of symptoms for those with dumping syndrome. Secondary endpoints were intraoperative complications, procedure time, length of hospital stay and diameter of gastrojejunal anastomosis 1 year post-intervention.

resultsThe median size of the gastrojejunal anastomosis was estimated at 30 mm before intervention, and after performing a median of 3 endoscopic sutures, the median estimated gastrojejunal anastomosis width was reduced to 9.5 mm. Eight perioperative complications occurred. Overall mean follow-up was 26.5 months. All interventions achieved weight stabilization or weight loss or resolution of dumping symptoms within the first 3 months, 98.2% at 12 months, 91.4% at 24 months and 75.0% at 48 months. In 22/26 subjects a persisting improvement of dumping syndrome was achieved.

conclusionsTORe is a safe and effective procedure in the treatment of patients with dumping syndrome after laparoscopic RYGB, the effect on weight stabilization is less significant. A prospective randomized trial should be conducted to compare the effects of TORe with other surgical methods like banding the gastrojejunal anastomosis.

Indexed as

Dumping SyndromeGastric BypassWeight GainAdultFemaleHumansJejunumMaleMiddle AgedObesity, MorbidRetrospective StudiesStomachSuture TechniquesTreatment OutcomeWeight LossBariatric surgeryDumping syndromeEndoscopyRoux-en-Y gastric bypassSecondary weight regainTransoral outlet reduction

Identifiers

PMID38914888
PMCPMC11289335

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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.