Author(s): Goyal V, Holover S, Garber S
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Abstract BACKGROUND: Gastric bypass is the "gold standard" procedure of bariatric surgery. However, 20.4-34.9\% of these patients may fail to achieve or maintain the weight loss on long-term follow-up and may require additional procedures. StomaphyX has been promoted for weight reduction in such patients. OBJECTIVES: To study whether endoluminal reduction of gastric pouch and stoma using StomaphyX results in sustained weight loss in patients who regain weight after gastric bypass. METHODS: Retrospective chart review was performed on 59 postgastric bypass patients who underwent revision of gastric pouch using StomaphyX from 2007 to 2008. Postprocedure weight at 1 week, 1 month, and 6 months follow-up as well as weight at the time of the review was recorded for each patient. RESULTS: Average weight loss and excess body weight loss (EBWL) were 2.6 ± 2.3 kg and 7.3 ± 7.1\% (n = 42) at 1 week, 3.7 ± 2.9 kg and 11.6 ± 12.1\% (n = 31) at 1 month, and 3.8 ± 4.5 kg and 11.5 ± 17.9\% (n = 10) at 6 months respectively. At the time of review, the average follow-up was 41 months, average weight loss was 1.7 ± 9.7 kg, and EBWL was 4.3 ± 29.8\% (n = 53). Endoscopy in 12 patients at average 18 months follow-up showed no sustained reduction in pouch and stoma size. CONCLUSIONS: StomaphyX results in weight loss that is not sustained on long-term follow-up. Pouch and stoma tend to regain their preprocedure size on follow-up. StomaphyX cannot be recommended as a weight loss strategy in postgastric bypass patients who regain weight.
This article was published in Surg Endosc
and referenced in Surgery: Current Research