Transoral outlet reduction: could additional sutures cause more harm?


Farha J., Gebran S., Itani M. I. , Simsek C. , Abbarh S., Lopez A., ...More

ENDOSCOPY, 2020 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2020
  • Doi Number: 10.1055/a-1325-4324
  • Title of Journal : ENDOSCOPY

Abstract

Background The double purse-string pattern (DPSP) of transoral outlet reduction (TORe) should conceivably result in a more robust scaffolding for the gastrojejunal anastomosis (GJA). However, there is a paucity of literature pertaining to post-TORe stenosis as an adverse event. Our aim was to determine the rate of stenosis, its potential predictors, and other complications of DPSP TORe. Methods We performed a retrospective analysis of a prospectively maintained database of 129 consecutive patients who underwent DPSP TORe between December 2015 and August 2019. Results The adverse event rate of TORe was 17.1% (n=22), with a 13.3% (n=17) rate of stenosis. Stenosis was not significantly associated with any baseline characteristics. GJA diameter pre- and post-TORe, the difference between these values, and procedure duration were not predictive of stenosis. Of patients who developed stenosis, 10 (58.8%) responded to endoscopic balloon dilation and 7 (41.2%) required stent placement. Conclusion As the DPSP technique is a challenging procedure, with high complication rate and limited benefit, it should not be used for TORe.