1. Transoral outlet reduction: Could additional sutures cause more harm?
- Author
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Farha, J., Gebran, S., Itani, M.I., Simsek, C., Abbarh, S., Lopez, A., Haq, Z., Koller, K., Dunlap, M., Adam, A., Khashab, M.A., Oberbach, A., Schweitzer, M., Badurdeen, D., Kumbhari, V., and Publica
- 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.
- Published
- 2021