Argon plasma coagulation alone versus argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass: a prospective randomized trial (with videos)

Brunaldi, Vítor Ottoboni; Farias, Galileu F.; Rezende, Daniel T.; Cairo-Nunes, Gabriel; Riccioppo, Daniel; Santo, Marco Aurélio; Moura, Eduardo Guimarães Hourneaux de

doi:10.1016/j.gie.2020.03.3757

Cited by 28 publications

(36 citation statements)

References 40 publications

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“…However, according to Jirapinyo et al, there was an increased incidence of nausea and vomiting with GJA < 4 mm 37 . The majority of the studies aimed for a GJA size < 10–12 mm 12 23 24 25 26 27 29 36 .…”

Section: Discussionmentioning

confidence: 99%

“…Technical success of TORe procedure with full-thickness suturing device was defined in 7 studies. Four studies 12 23 24 25 considered post procedure GJA size < 10 mm and four studies 26 27 28 29 considered post-procedure GJA size < 12 mm to be technically successful.…”

Section: Methodsmentioning

confidence: 99%

“…Four studies [12, 23-25] ▶ Table 1 Quality assessment of the study with Newcastle Ottawa Scale and Jadad scale. considered post procedure GJA size < 10 mm and four studies [26][27][28][29] considered post-procedure GJA size < 12 mm to be technically successful. Absolute weight loss was calculated using the formula TORe weight-follow up weight and TWL was defined as (TORe weight-follow up weight)/TORe weight x 100 %.…”

Section: Definition Of Outcomesmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Definition Of Outcomesmentioning

confidence: 99%

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

et al. 2020

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“…Clinically, plasma-based electrosurgical devices have long been employed for blood and tissue coagulation, cutting, desiccation, and cauterising during surgery [163,164]. These devices involve heating tissue and their effects are primarily heat mediated.…”

Section: Plasma Physical and Chemical Characteristics And Plasma Sourmentioning

confidence: 99%

Cold Atmospheric Pressure Plasma (CAP) as a New Tool for the Management of Vulva Cancer and Vulvar Premalignant Lesions in Gynaecological Oncology

Žúbor

Wang

Líšková

et al. 2020

IJMS

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Vulvar cancer (VC) is a specific form of malignancy accounting for 5–6% of all gynaecologic malignancies. Although VC occurs most commonly in women after 60 years of age, disease incidence has risen progressively in premenopausal women in recent decades. VC demonstrates particular features requiring well-adapted therapeutic approaches to avoid potential treatment-related complications. Significant improvements in disease-free survival and overall survival rates for patients diagnosed with post-stage I disease have been achieved by implementing a combination therapy consisting of radical surgical resection, systemic chemotherapy and/or radiotherapy. Achieving local control remains challenging. However, mostly due to specific anatomical conditions, the need for comprehensive surgical reconstruction and frequent post-operative healing complications. Novel therapeutic tools better adapted to VC particularities are essential for improving individual outcomes. To this end, cold atmospheric plasma (CAP) treatment is a promising option for VC, and is particularly appropriate for the local treatment of dysplastic lesions, early intraepithelial cancer, and invasive tumours. In addition, CAP also helps reduce inflammatory complications and improve wound healing. The application of CAP may realise either directly or indirectly utilising nanoparticle technologies. CAP has demonstrated remarkable treatment benefits for several malignant conditions, and has created new medical fields, such as “plasma medicine” and “plasma oncology”. This article highlights the benefits of CAP for the treatment of VC, VC pre-stages, and postsurgical wound complications. There has not yet been a published report of CAP on vulvar cancer cells, and so this review summarises the progress made in gynaecological oncology and in other cancers, and promotes an important, understudied area for future research. The paradigm shift from reactive to predictive, preventive and personalised medical approaches in overall VC management is also considered.

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“…[11][12][13] In this sense, the narrowing of the dilated GJA through argon plasma coagulation (APC) in the recurrence of obesity, in patients undergoing RYGB, presents itself as an effective and safe alternative, according to important published works. [14][15][16][17][18] As a consequence of weight gain after RYGB, abnormal anatomical findings are found in 71.2% of patients, with 58.9% presenting with GJA dilation. [18] Therefore, APC is technically feasible and reproducible, relatively inexpensive, and with numerous advantages over the usual electrocoagulation.…”

Section: Introductionmentioning

confidence: 99%

OUTLET ROUX-Y-GASTRIC BYPASS POUCH REDUCTION USING ARGON PLASMA COAGULATION TO TREAT WEIGHT REGAIN: A Randomized Controlled Trial with SHAM Group

Zotarelli-Filho¹

2021

Preprint

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Aims: This study to evaluate the efficacy and complications of Argon Plasma Coagulation (APC) therapy to treat post-RYGB weight regain compared to a sham control group. Methods: 41 Patients with minimum regain of 10 kg and minimal postoperative time of 36 months was randomized into two groups. Results: In the APC group (n=21), the mean initial weight 100.4 kg, and mean regained weight of 24.94 kg. In the Sham group (n=20), the mean initial weight of 103.65 kg, and mean regained weight of 25.18 kg. Only happened anastomosis stenosis after the first APC session. The comparative results between the APC versus the Sham were percentage recovered weight loss (63.95 x-2.65), weight loss in kg (15.02 x-0.57), percentage total weight loss (14.46 x-0.62), % excess weight loss (54.32 x-2.34), and BMI reduction (5.38 x-0.21), with a p<0.0001 for all the comparisons. There was a significant reduction in the APC group of HbA1c (5.66% to 4.96%) and triglycerides (153.20mg/dL to 132.20mg/dL). Conclusion: This study proves that APC outlet pouch reduction is much superior compared to sham in promoting weight loss for patients that presented weight regain after de RYGB.

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Argon plasma coagulation alone versus argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass: a prospective randomized trial (with videos)

Cited by 28 publications

References 40 publications

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

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

Cold Atmospheric Pressure Plasma (CAP) as a New Tool for the Management of Vulva Cancer and Vulvar Premalignant Lesions in Gynaecological Oncology

OUTLET ROUX-Y-GASTRIC BYPASS POUCH REDUCTION USING ARGON PLASMA COAGULATION TO TREAT WEIGHT REGAIN: A Randomized Controlled Trial with SHAM Group

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