Dose response for argon plasma coagulation in the treatment of weight regain after Roux-en-Y gastric bypass - 20/04/20
Abstract |
Background and Aims |
Argon plasma coagulation (APC) of gastrojejunal anastomosis (GJA) is effective in treating weight regain after Roux-en-Y gastric bypass (RYGB). This study aims to compare the efficacy of different APC settings for treating weight regain.
Methods |
This was a single-center retrospective study of patients who had undergone RYGB and then underwent APC from 2014 to 2018 for weight regain. Patients receiving only low-dose APC (45-55 W) or high-dose APC (70-80 W) were compared. The primary outcome was the difference in percentage total weight loss (% TWL) between the groups at 6 and 12 months after the last treatment. Secondary outcomes were technical success, adverse events (AEs), and predictors of weight loss at 12 months.
Results |
Two hundred seventeen patients met the inclusion criteria and underwent 411 APC sessions. Of these, 116 (53.5%) patients underwent 267 low-dose APC sessions (2.4 ± 1.5 sessions/patient) and 101 (46.5%) patients underwent 144 high-dose APC sessions (1.4 ± 0.7 sessions/patient). Follow-up rates were 82.9% and 75.3% at 6 and 12 months. At 6 months, the low- and high-dose groups experienced 7.3% ± 6.6% and 8.1% ± 7.4% TWL, respectively (P = .41). At 12 months, the low- and high-dose groups experienced 5.1% ± 8.5% and 9.7% ± 10.0% TWL, respectively (P = .008). Technical success was 100%. The overall AE rate was 8.0%; the most common AE was GJA stenosis (4.6%). The GJA stenosis rate was similar for the low- and high-dose groups (3.0% vs 7.6%, P = .06). High-dose APC remained a significant predictor of greater weight loss at 1 year after controlling for confounders.
Conclusion |
APC is effective at treating weight regain after RYGB, and higher-watt APC was associated with greater weight loss.
Le texte complet de cet article est disponible en PDF.Abbreviations : AE, APC, ASGE, AWL, BMI, GJA, LAMS, OR, PPI, RYGB, TORe, TWL
Plan
| DISCLOSURE: Dr Jirapinyo has received research support from Apollo Endosurgery, Fractyl, and GI Dynamics, and has served as a consultant to Endogastric Solutions and GI Dynamics. Dr Thompson has served as a consultant for Boston Scientific, Apollo Endosurgery, Fractyl, USGI Medical, Medtronic/Covidien, Olympus/Spiration, and GI Dynamics, has served as an advisory boards member for USGI Medical and Fractyl, has received a research grant and support from USGI Medical, Apollo Endosurgery, Olympus/Spiration, Aspire Bariatrics, Spatz, and GI Dynamics, has served as a general partner for Blueframe Healthcare, and holds stock and royalties for GI Windows. All other authors disclosed no financial relationships. |
Vol 91 - N° 5
P. 1078-1084 - mai 2020 Retour au numéro
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