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de Quadros LG, Faria DCG, Neto MG, Brunaldi V, Zotarelli Filho IJ, Faria MAG, Grecco E, Flamini Junior M, Martins SFS, Teixeira A, de Andrade CB, Ferraz AAB, Kaiser Junior RL. Banded RYGB Ring Slippage Endoscopic Removal with Self-expandable Stents: a Comparative Study Between Metallic and Plastic One. Obes Surg 2021; 32:115-122. [PMID: 34642873 DOI: 10.1007/s11695-021-05742-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Banded Roux-en-Y gastric bypass (RYGB) was a common bariatric procedure in the 2000s, and the ring slippage is one of its late adverse events. Both plastic and metallic stents have been reported as adjunct methods to induce erosion and facilitate endoscopic removal of the ring. OBJECTIVE To compare the safety and effectiveness of self-expanding metallic stents (SEMS) and plastic stents (SEPS) to treat ring slippage. MATERIALS AND METHODS We conducted a retrospective longitudinal study analyzing consecutive patients with ring dysfunction treated with stents plus endoscopic removal. RESULTS Ninety patients were enrolled (36 SEMS vs. 54 SEPS). The mean age was 48.56 ± 13.07 and 45.6 ± 12.1 in the SEMS and SEPS groups, respectively. All patients had band slippage, but 24 from SEMS group and 23 from SEPS group had further complications. There were more complications in metallic stent concerning mean absolute number of therapy-related adverse events (1.33 ± 0.48 vs. 1.72 ± 0.5, p > 0.05) and time until erosion (14.9 ± 1.6 vs. 13.8 ± 1.4 days, p > 0.05). Female sex and age > 41 years old correlated with longer time to band erosion and higher incidence of adverse events in SEMS patients. In SEPS group, only female sex was a risk factor for adverse events. CONCLUSION Both procedures were efficient at inducing band erosion with similar safety profiles. Older and female patients are at a higher risk of treatment-related adverse events, especially those receiving SEMS.
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Affiliation(s)
- Luiz Gustavo de Quadros
- Beneficencia Portuguesa Hospital, São Jose Do Rio Preto, Brazil. .,Faculty of Medicine of ABC, Santo André, Brazil. .,Faculty of Medicine of São José do Rio Preto, FAMERP, São José do Rio Preto, Brazil. .,Kaiser Clinic, Street XV de Novembro, 3975, Redentora, Sao Jose Do Rio Preto, SP, CEP 15015-110, Brazil.
| | | | - Manoel Galvão Neto
- Faculty of Medicine of ABC, Santo André, Brazil.,Endovitta Institute, São Paulo, Brazil
| | - Vitor Brunaldi
- Center of Gastrointestinal Endoscopy, Surgery and Anatomy Department, Ribeirao Preto Faculty of Medicine, University of Sao Paulo, Ribeirão Preto, Brazil
| | | | | | - Eduardo Grecco
- Faculty of Medicine of ABC, Santo André, Brazil.,Endovitta Institute, São Paulo, Brazil.,University of Sao Caetano Do Sul, São Caetano do Sul, Brazil
| | - Mario Flamini Junior
- Kaiser Clinic, Street XV de Novembro, 3975, Redentora, Sao Jose Do Rio Preto, SP, CEP 15015-110, Brazil
| | | | | | | | | | - Roberto Luiz Kaiser Junior
- Faculty of Medicine of São José do Rio Preto, FAMERP, São José do Rio Preto, Brazil.,Kaiser Clinic, Street XV de Novembro, 3975, Redentora, Sao Jose Do Rio Preto, SP, CEP 15015-110, Brazil
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Vilallonga R, Pereira-Cunill JL, Morales-Conde S, Alarcón I, Breton I, Domínguez-Adame E, Ferrer JV, Ruiz-de-Gordejuela AG, Goday A, Lecube A, García-Almenta EM, Rubio MÁ, Tinahones FJ, García-Luna PP. A Spanish Society joint SECO and SEEDO approach to the Post-operative management of the patients undergoing surgery for obesity. Obes Surg 2020; 29:3842-3853. [PMID: 31342249 DOI: 10.1007/s11695-019-04043-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Bariatric surgery is the method of choice for the management or treatment of obesity. Bariatric surgery brings about several physiological changes in the body and is associated with set of complications. The aim of this study is to provide guidelines on post bariatric surgery management based on consensus by the Spanish society for Obesity Surgery (Sociedad Española de Cirugía de la Obesidad) (SECO) and the Spanish Society for the Study of Obesity (Sociedad Española para el Estudio de la Obesidad) (SEEDO). METHOD The boards proposed seven experts from each society. The experts provided the evidence and a grade of recommendation on the selected topics based on systematic reviews/meta-analysis. A list of clinical practical recommendations levels of evidence and grades of these recommendations was derived from the consensus statements from the members of these societies. RESULTS Seventeen topics related to post-operative management were reviewed after bariatric surgery. The experts came with 47 recommendations and statements. The mean number of persons voting at each statement was 54 (range 36-76). CONCLUSION In this consensus, we have designed a set of guidelines to be followed while managing patients after bariatric surgery. Expertise and knowledge of the clinicians are required to convey suitable considerations to the post-bariatric patients. There should also be extensive follow-up plans for the bariatric surgery patients.
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Affiliation(s)
- R Vilallonga
- Endocrine, metabolic and bariatric Unit, General Surgery Department, Hospital Vall d'Hebron, Center of Excellence for the EAC-BC, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J L Pereira-Cunill
- Clinical Nutritión Unit, Endocrinology and Nutrition Service, University Hospital "Virgen del Rocío", Seville, Spain
| | - S Morales-Conde
- Unit of Innovation in Minimally Invasive Surgery, Department of Surgery, University Hospital "Virgen del Rocío", Hospital Quironsalud Sagrado Corazón, University of Sevilla, Sevilla, Spain
| | - I Alarcón
- Unit of Innovation in Minimally Invasive Surgery, Department of Surgery, University Hospital "Virgen del Rocío", Hospital Quironsalud Sagrado Corazón, University of Sevilla, Sevilla, Spain
| | - I Breton
- Unidad de Nutrición Clínica y Dietética del Servicio de Endocrinología y Nutrición del Hospital Gregorio Marañón, Madrid, Spain
| | - E Domínguez-Adame
- UGC Cirugía General y Aparato Digestivo, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain
| | | | - A Garcia Ruiz-de-Gordejuela
- Endocrine, metabolic and bariatric Unit, General Surgery Department, Hospital Vall d'Hebron, Center of Excellence for the EAC-BC, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Goday
- Servicio de Endocrinología, Hospital del Mar de Barcelona, Departament de Medicina, CIBERobn, ISCIII, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Lecube
- Servicio deEndocrinología y Nutrición, Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida (IRBLleida), Universitat de Lleida (UdL), Avda. Rovira Roure, 80 25198, Lleida, Spain
| | - E Martín García-Almenta
- Unidad Cirugía Esófago-Gástrica, Metabólica y Bariátrica, Hospital Clínico San Carlos, Madrid, Spain
| | - M Á Rubio
- Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos, Idissc, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - F J Tinahones
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria de Malaga, Málaga, Spain
| | - P P García-Luna
- Unidad de Nutrición Clínica y de la Unidad de Obesidad Mórbida (Unidad de Gestión de Endocrinología y Nutrición, UGEN), Hospital Universitario Virgen del Rocío, Seville, Spain
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Nedelcu M, Noel P. Ring-banded sleeve gastrectomies: can we prevent the dilation? Surg Obes Relat Dis 2017; 13:1265. [PMID: 28528710 DOI: 10.1016/j.soard.2017.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 04/07/2017] [Accepted: 04/07/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Marius Nedelcu
- Clinique Saint Michel-Centre Chirurgical de l'Obesite, Toulon, France
| | - Patrick Noel
- Clinique Saint Michel-Centre Chirurgical de l'Obesite, Toulon, France; The American Surgecenter, Abu Dhabi, United Arab Emirates
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Abstract
Primary banding of Roux-en-Y gastric bypass remains controversial. Though there are surgeons who believe it should be the standard practice as it results in superior weight loss and prevents weight regain in the long term, there are others who are concerned about the risk of food intolerance and complications related to band. This review investigates published English language literature systematically to find out the advantages and disadvantages of primary banding of a Roux-en-Y gastric bypass.
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Karcz WK, Karcz-Socha I, Marjanovic G, Kuesters S, Goos M, Hopt UT, Szewczyk T, Baumann T, Grueneberger JM. To band or not to band--early results of banded sleeve gastrectomy. Obes Surg 2015; 24:660-5. [PMID: 24464518 DOI: 10.1007/s11695-014-1189-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Laparoscopic sleeve gastrectomy (LSG) is the procedure with the fastest growing numbers worldwide. Although excellent weight loss can be achieved, one major obstacle of LSG is weight regain due to sleeve dilatation. Banded sleeve gastrectomy (BLSG) has been described as an option to counteract sleeve dilatation and ameliorate weight loss over time. In a retrospective study, we analysed 25 patients who underwent BLSG using a MiniMizer® ring. Twenty five patients who had previously undergone a conventional LSG were selected for matched-pair analysis. Patient follow-up was 12 months in both groups. Mean preoperative BMI was 56.1 ± 7.2 kg/m(2) for BLSG and 57.0 ± 6.3 kg/m(2) for LSG, P = 0.522. Operative time was significantly shorter for BLSG (53 ± 27 min vs. 68 ± 20 min, P = 0.0025). Excess weight loss (%EWL) was equal in both groups with %EWL at 12 months of 58.0 ± 14.6 % for BSLG patients vs. 58.4 ± 19.2 % for LSG patients. There was no procedure-related mortality in either group. At 12 months postoperative, vomiting was significantly increased in BSLG patients (OR 6.75, P = 0.035). New onset reflux was equal in both groups (OR 0.67, P = 0.469). Ring implantation does not increase the duration of surgery or early surgical complications. Weight loss in the first follow-up year is not influenced, but the incidence of vomiting is raised after 12 months when patients start to increase eating volume.
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Affiliation(s)
- W Konrad Karcz
- Department of General Surgery, University of Schleswig-Holstein, Campus, Lübeck, Germany
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Galvão Neto M, Marins Campos J. Therapeutic flexible endoscopy after bariatric surgery: a solution for complex clinical scenarios. Cir Esp 2014; 93:1-3. [PMID: 24814987 DOI: 10.1016/j.ciresp.2014.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Manoel Galvão Neto
- Gastro Obeso Center, São Paulo, Brasil; Investigational Surgical and Endoscopic Procedures Committee, International Federation of the Surgery of Obesity (IFSO).
| | - Josemberg Marins Campos
- Investigational Surgical and Endoscopic Procedures Committee, International Federation of the Surgery of Obesity (IFSO); Sociedad Brasileña de Cirugía Bariátrica y Metabólica; Universidade Federal de Pernambuco, Pernambuco, Brasil
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Reply to the article Espinós JC, Turró R, Mata A, Cruz M, da Costa M, Villa V, Buchwald JN, Turró J. Early experience with the Incision less Operating Platform™ (IOP) for the treatment of obesity: the Primary Obesity Surgery Endolumenal (POSE) procedure. Obes Surg. 2013;23:1375-83. Obes Surg 2013; 24:422-3. [PMID: 24347348 DOI: 10.1007/s11695-013-1146-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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