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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(04): E426-E434
DOI: 10.1055/a-2029-1845
Original article

Roux-en-Y gastric bypass pouch outlet reduction using argon plasma coagulation to treat weight regain: a randomized controlled trial with a sham control group

Ricardo José Fittipaldi-Fernandez
1   EndogastroRio Clinic, Rio de Janeiro/RJ, Brazil
,
Idiberto José Zotarelli-Filho
2   FACERES – Faculty of Medicine of Sao Jose do Rio Preto/SP, Brazil
3   ABRAN - Associação Brasileira de Nutrologia/Brazilian Association of Nutrology, Catanduva, Sao Paulo, Brazil
4   Zotarelli-Filho Scientific Work, Sao Jose do Rio Preto/SP, Brazil
,
Marcelo Falcão de Santana
5   IFEC-Instituto Falcão de Endoscopia e Cirurgia (Falcão Institute of Endoscopy and Surgery), Salvador/BA, Brazil
6   EBMSP-Escola Bahiana de Medicina e Saúde Pública (Bahiana School of Medicine and Public Health), Salvador/BA, Brazil
,
João Henrique Felicio de Lima
7   Endobatel–Digestive endoscopy, Universidade Federal do Paraná-UFPR (Federal University of Paraná), Curitiba/PR, Brazil
,
Fernando Santos Silva Bastos
5   IFEC-Instituto Falcão de Endoscopia e Cirurgia (Falcão Institute of Endoscopy and Surgery), Salvador/BA, Brazil
6   EBMSP-Escola Bahiana de Medicina e Saúde Pública (Bahiana School of Medicine and Public Health), Salvador/BA, Brazil
,
Sérgio Alexandre Barrichello-Junior
8   GI Endoscopy-Health Me Clinic, Sao Paulo, Brazil
,
Newton Teixeira dos Santos
9   NT Santos Serviços médicos (NT Santos-Medical services), Rio de Janeiro/RJ, Brazil
,
Marcella Guedes
1   EndogastroRio Clinic, Rio de Janeiro/RJ, Brazil
,
Aline Fittipaldi-Fernandez
1   EndogastroRio Clinic, Rio de Janeiro/RJ, Brazil
› Author AffiliationsSupported by: EndogastroRio Clinic, Rio de Janeiro-RJ, Brazil

TRIAL REGISTRATION: Prospective, Randomized ENDOG2356 at Brazilian Clinical Trials Registry
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Abstract

Background and study aims A comparative study was conducted to evaluate the efficacy of argon plasma coagulation (APC) therapy in treating post Roux-en-Y gastric bypass (RYGB) weight regain and the incidence of complications related to this procedure, using a sham treatment group as a control.

Patients and methods Forty-one patients with a minimum weight regain of 10 kg and a minimum postoperative time of 36 months were randomized into two groups.

Results In the APC group (n = 21), the mean initial weight was 100.4 kg and the mean weight regain was 24.94 kg. In the sham group (n = 20), the mean initial weight was 103.65 kg, and the mean weight regain was 25.18 kg. Anastomotic stenosis occurred only after the first APC session. The results for the comparison of APC with the sham group showed a percentage weight regain loss of 63.95 compared to -.65, and weight loss of 15.02 and –0.57), percentage total weight loss of 14.46 and –0.62, excess weight loss of 54.32 % and –2.34 %), and BMI reduction of 5.38 and –0.21, with P < 0.0001 for all the comparisons. In the APC group, there was a significant reduction in HbA1c (5.66 % to 4.96 %) and triglycerides (153.20 mg/dL to 132.20 mg/dL).

Conclusions This study indicates that APC outlet pouch reduction outperforms sham treatment in terms of weight loss for patients presenting weight regain after RYGB.



Publication History

Received: 31 October 2022

Accepted after revision: 30 January 2023

Accepted Manuscript online:
06 February 2023

Article published online:
28 April 2023

© 2023. 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 commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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