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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(10): E1332-E1340
DOI: 10.1055/a-1214-5822
Original article

Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis

Banreet Singh Dhindsa
1   Department of Internal Medicine, University of Nebraska Medical Center, Las Vegas, Nevada, United States
,
Syed Mohsin Saghir
1   Department of Internal Medicine, University of Nebraska Medical Center, Las Vegas, Nevada, United States
,
Yassin Naga
1   Department of Internal Medicine, University of Nebraska Medical Center, Las Vegas, Nevada, United States
,
Amaninder Dhaliwal
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Las Vegas, Nevada, United States
,
Dayl Ramai
3   Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, United States
,
Chad Cross
4   Department of Biostatistics and Epidemiology, University of Nevada Las Vegas, Las Vegas, Nevada, United States
,
Shailender Singh
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Las Vegas, Nevada, United States
,
Ishfaq Bhat
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Las Vegas, Nevada, United States
,
Douglas G. Adler
5   Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah
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Abstract

Background and study aims Transoral outlet reduction (TORe) is an endoscopic procedure used in patients with weight gain post Roux-en-Y gastric bypass (RYGB). We performed a systematic review and meta-analysis to evaluate the efficacy and safety of TORe with a full-thickness suturing device for treating patients with weight regain after RYGB.

Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to March 2020). The primary outcomes assessed were technical success, absolute weight loss (AWL) and percent of total weight loss (% TWL) at 3, 6, and 12 months after the procedure. The secondary outcomes assessed were pooled rate of adverse events (AEs), adverse event subtypes and association of size of gastrojejunal anastomosis (GJA) and percent TWL.

Results Thirteen studies on 850 patients were included. The pooled rate of technical success was 99.89 %. The absolute weight loss (kg) at 3, 6, and 12 months was 6.14, 10.15, and 7.14, respectively. The percent TWL at 3, 6, and 12 months was 6.69, 11.34, and 8.55, respectively. The pooled rate of AE was 11.4 % with abdominal pain being the most common adverse event. The correlation coefficient (r) was –0.11 between post TORe GJA size and weight loss at 12 months.

Conclusion TORe is an endoscopic procedure that is safe and technically feasible for post RYGB with weight gain.

Supplementary material



Publication History

Received: 08 April 2020

Accepted: 22 May 2020

Article published online:
22 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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