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Transoral outlet reduction: could additional sutures cause more harm?
Jad Farha1, Selim Gebran2, Mohamad I Itani1
1Department of Medicine, Division of Gastroenterology and Hepatology, The Johns Hopkins Hospital, Baltimore, Maryland, United States.
Endoscopy
|November 30, 2020
Summary
The double purse-string pattern (DPSP) transoral outlet reduction (TORe) has a high stenosis rate (13.3%) and complications. This DPSP TORe technique is not recommended due to limited benefits and challenges.
Area of Science:
- Bariatric Surgery
- Gastroenterology
- Surgical Techniques
Background:
- The double purse-string pattern (DPSP) for transoral outlet reduction (TORe) aims to create robust gastrojejunal anastomosis (GJA) scaffolding.
- Literature on post-TORe stenosis as an adverse event is limited.
Purpose of the Study:
- To determine the rate of stenosis after DPSP TORe.
- To identify predictors of stenosis and other complications associated with DPSP TORe.
Main Methods:
- Retrospective analysis of 129 patients undergoing DPSP TORe from December 2015 to August 2019.
- Evaluation of adverse event rates, stenosis rates, and associated factors.
Main Results:
- The overall adverse event rate was 17.1%, with a stenosis rate of 13.3%.
- Stenosis was not significantly linked to baseline characteristics, GJA diameter, or procedure duration.
- Stenosis management included endoscopic balloon dilation (58.8%) and stent placement (41.2%).
Conclusions:
- The DPSP technique for TORe presents a high complication rate and limited benefits.
- The DPSP technique is not recommended for transoral outlet reduction procedures.
