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Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery.
Surg Obes Relat Dis. 2016 Mar-Apr; 12(3):582-586.SO

Abstract

INTRODUCTION

Roux-en-Y gastric bypass is a commonly used technique of bariatric surgery. One of the most important complications is gastrojejunal anastomotic stricture. Endoscopic balloon dilation appears to be well tolerated and effective, but well-designed randomized, controlled trials have not yet been conducted.

OBJECTIVE

Identify factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery.

SETTING

Gastrointestinal endoscopy service, university hospital, Brazil.

METHODS

The records of 64 patients with anastomotic stricture submitted to endoscopic dilation with hydrostatic balloon dilation were reviewed. Information was collected on gastric pouch length, anastomosis diameter before dilation, number of dilation sessions, balloon diameter at each session, anastomosis diameter after the last dilation session, presence of postsurgical complications, endoscopic complications, and outcome of dilation. Comparisons were made among postsurgical and endoscopic complications; number of dilations, balloon diameter; anastomosis diameter before dilation; and dilation outcome.

RESULTS

Success of dilation treatment was 95%. Perforation was positively and significantly associated with the number of dilation sessions (P = .03). Highly significant associations were found between ischemic segment and perforation (P<.001) and between ischemic segment and bleeding (P = .047). Ischemic segment (P = .02) and fistula (P = .032) were also associated with dilation failure.

CONCLUSION

Ischemic segment and fistula were found to be important risk factors for balloon dilation failure. The greater the number of dilation sessions, the greater the number of endoscopic complications.

Authors+Show Affiliations

Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; Gastrointestinal Endoscopy Service, Hospital São Luiz Morumbi, São Paulo, Brazil.Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; Gastroclínica Cascavel - Assis Gurgacz Medical School, Paraná, Brazil. Electronic address: ivan@gastro.com.br.Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27174245

Citation

de Moura, Eduardo G H., et al. "Factors Associated With Complications or Failure of Endoscopic Balloon Dilation of Anastomotic Stricture Secondary to Roux-en-Y Gastric Bypass Surgery." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 12, no. 3, 2016, pp. 582-586.
de Moura EGH, Orso IRB, Aurélio EF, et al. Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12(3):582-586.
de Moura, E. G. H., Orso, I. R. B., Aurélio, E. F., de Moura, E. T. H., de Moura, D. T. H., & Santo, M. A. (2016). Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 12(3), 582-586. https://doi.org/10.1016/j.soard.2015.11.006
de Moura EGH, et al. Factors Associated With Complications or Failure of Endoscopic Balloon Dilation of Anastomotic Stricture Secondary to Roux-en-Y Gastric Bypass Surgery. Surg Obes Relat Dis. 2016 Mar-Apr;12(3):582-586. PubMed PMID: 27174245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. AU - de Moura,Eduardo G H, AU - Orso,Ivan R B, AU - Aurélio,Eduardo F, AU - de Moura,Eduardo T H, AU - de Moura,Diogo T H, AU - Santo,Marco A, Y1 - 2015/11/14/ PY - 2015/05/22/received PY - 2015/11/02/revised PY - 2015/11/11/accepted PY - 2016/5/14/entrez PY - 2016/5/14/pubmed PY - 2017/10/12/medline KW - Bariatric surgery KW - Endoscopic dilation KW - Endoscopy KW - Morbid obesity KW - Stenosis SP - 582 EP - 586 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 12 IS - 3 N2 - INTRODUCTION: Roux-en-Y gastric bypass is a commonly used technique of bariatric surgery. One of the most important complications is gastrojejunal anastomotic stricture. Endoscopic balloon dilation appears to be well tolerated and effective, but well-designed randomized, controlled trials have not yet been conducted. OBJECTIVE: Identify factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. SETTING: Gastrointestinal endoscopy service, university hospital, Brazil. METHODS: The records of 64 patients with anastomotic stricture submitted to endoscopic dilation with hydrostatic balloon dilation were reviewed. Information was collected on gastric pouch length, anastomosis diameter before dilation, number of dilation sessions, balloon diameter at each session, anastomosis diameter after the last dilation session, presence of postsurgical complications, endoscopic complications, and outcome of dilation. Comparisons were made among postsurgical and endoscopic complications; number of dilations, balloon diameter; anastomosis diameter before dilation; and dilation outcome. RESULTS: Success of dilation treatment was 95%. Perforation was positively and significantly associated with the number of dilation sessions (P = .03). Highly significant associations were found between ischemic segment and perforation (P<.001) and between ischemic segment and bleeding (P = .047). Ischemic segment (P = .02) and fistula (P = .032) were also associated with dilation failure. CONCLUSION: Ischemic segment and fistula were found to be important risk factors for balloon dilation failure. The greater the number of dilation sessions, the greater the number of endoscopic complications. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/27174245/Factors_associated_with_complications_or_failure_of_endoscopic_balloon_dilation_of_anastomotic_stricture_secondary_to_Roux_en_Y_gastric_bypass_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(15)01046-1 DB - PRIME DP - Unbound Medicine ER -