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Pontecorvi, Valerio; Matteo, Maria Valeria; Bove, Vincenzo; De Siena, Martina; Giannetti, Giulia; Carlino, Giorgio; Polidori, Giulia; Vinti, Laila; Angelini, Giulia; Iaconelli, Amerigo; Familiari, Pietro; Raffaelli, Marco; Costamagna, Guido; Boškoski, Ivo

Long-term Outcomes of Transoral Outlet Reduction (TORe) for Dumping Syndrome and Weight Regain After Roux-en-Y Gastric Bypass

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  • Media type: E-Article
  • Title: Long-term Outcomes of Transoral Outlet Reduction (TORe) for Dumping Syndrome and Weight Regain After Roux-en-Y Gastric Bypass
  • Contributor: Pontecorvi, Valerio; Matteo, Maria Valeria; Bove, Vincenzo; De Siena, Martina; Giannetti, Giulia; Carlino, Giorgio; Polidori, Giulia; Vinti, Laila; Angelini, Giulia; Iaconelli, Amerigo; Familiari, Pietro; Raffaelli, Marco; Costamagna, Guido; Boškoski, Ivo
  • Published: Springer Science and Business Media LLC, 2023
  • Published in: Obesity Surgery, 33 (2023) 4, Seite 1032-1039
  • Language: English
  • DOI: 10.1007/s11695-023-06466-w
  • ISSN: 0960-8923; 1708-0428
  • Origination:
  • Footnote:
  • Description: AbstractBackgroundBoth weight regain and dumping syndrome (DS) after Roux-en-Y gastric bypass (RYGB) have been related to the dilation of gastro-jejunal anastomosis. The aim of this study is to assess the safety and long-term efficacy of endoscopic transoral outlet reduction (TORe) for DS and/or weight regain after RYBG.Materials and MethodsA retrospective analysis was performed on a prospective database. Sigstad’s score, early and late Arts Dumping Score (ADS) questionnaires, absolute weight loss (AWL), percentage of total body weight loss (%TBWL), and percentage of excess weight loss (%EWL) were assessed at baseline and at 6, 12, and 24 months after TORe.ResultsEighty-seven patients (median age 46 years, 79% female) underwent TORe. The median baseline BMI was 36.2 kg/m2. Out of 87 patients, 58 were classified as “dumpers” due to Sigstad’s score ≥ 7. The resolution rate of DS (Sigstad’s score < 7) was 68.9%, 66.7%, and 57.2% at 6, 12, and 24 months after TORe, respectively. A significant decrease in Sigstad’s score as well as in early and late ADS questionnaires was observed (p< 0.001). The median Sigstad’s score dropped from 15 (11–8.5) pre-operatively to 2 (0–12) at 24 months. The %TBWL was 10.5%, 9.9%, and 8.1% at 6, 12, and 24 months, respectively. Further, “dumpers” with resolution of DS showed better weight loss results compared with those with persistent DS (p< 0.001). The only adverse event observed was a perigastric fluid collection successfully managed conservatively.ConclusionTORe is a minimally invasive treatment for DS and/or weight regain after RYGB, with evidence of long-term efficacy.Graphical Abstract