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Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
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GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION
Luciana T Siqueira1, Fernando Santa-Cruz2, João Paulo Pontual3
1Hospital das Clínicas da Universidade Federal de Pernambuco, General Surgery Service - Recife - PE, Brazil.
Summary
Gastric twist after sleeve gastrectomy (SG) is rare, typically mild, and often asymptomatic. A new endoscopic classification was developed but showed no statistical link to patient symptoms or esophagitis severity.
Area of Science:
- Gastroenterology
- Bariatric Surgery
- Endoscopy
Background:
- Gastric twisting is a significant cause of persistent reflux and food intolerance post-sleeve gastrectomy (SG).
- Currently, no standardized classification exists for gastric twist following SG.
Purpose of the Study:
- To introduce a novel endoscopic classification system for gastric twist after SG.
- To describe the clinical characteristics of patients experiencing gastric twist post-SG.
Main Methods:
- Patients with endoscopic evidence of gastric twist after SG were included.
- Esophagogastroduodenoscopy was performed 12 months post-SG.
- A three-degree classification (I, II, III) based on staple line rotation and lumenal narrowing was proposed.
Main Results:
- Gastric twist occurred in 1.6% (45/2723) of SG patients.
- The majority (91.1%) had mild (Degree I) twisting.
- Most patients were asymptomatic (60%), with vomiting being the most common symptom (15.5%).
Conclusions:
- Gastric twist is an uncommon complication of SG, usually presenting mildly and without symptoms.
- The proposed endoscopic classification did not correlate statistically with clinical presentation but provides a basis for future research.
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