Transoral Outlet Reduction in Treating Dumping Syndrome after Roux-En-Y Gastric Bypass: A Systematic Review and...

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Endoscopic Procedures

Background:

• Dumping syndrome (DS) frequently complicates Roux-en-Y gastric bypass (RYGB), causing significant gastrointestinal and neurohumoral symptoms.
• Current therapeutic options for DS include conservative management and surgical interventions, but their comparative effectiveness is not well-established.
• Transoral outlet reduction (TORe) is an endoscopic therapy utilized for DS, yet comprehensive data on its efficacy is limited.

Purpose of the Study:

• To conduct a meta-analysis evaluating the effectiveness of transoral outlet reduction (TORe) as a treatment for dumping syndrome (DS) following Roux-en-Y gastric bypass (RYGB).
• To synthesize available data from retrospective studies to provide an overview of TORe's success rates and impact on DS symptoms.

Main Methods:

• A systematic literature search was performed across five databases to identify relevant retrospective studies on TORe for DS.
• Ten retrospective studies, involving a total of 320 patients, met the inclusion criteria for the meta-analysis.
• The primary outcome measure for evaluating TORe effectiveness was the resolution of DS symptoms, assessed using the Sigstad score.

Main Results:

• The meta-analysis included ten studies with 320 patients, revealing a pooled success rate of 95.59% for TORe in improving DS symptoms.
• TORe resulted in a significant average reduction of the Sigstad score by 8.71 points (p < 0.001), indicating consistent improvement in DS severity.
• Significant weight loss was also observed as a secondary outcome (p < 0.001) following the TORe procedure.

Conclusions:

• Transoral outlet reduction (TORe) demonstrates considerable efficacy as an endoluminal treatment for dumping syndrome (DS) post-RYGB.
• Limitations include the retrospective nature of the included studies, lack of long-term follow-up, and varied outcome measures.
• Future research should prioritize prospective trials with standardized outcomes, including objective measures, and comparative studies against surgical interventions to fully ascertain TORe's efficacy and durability.