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Endoscopic transoral outlet reduction induces enterohormonal changes in patients with weight regain after Roux-en-Y gastric bypass.
Brunaldi, Vitor Ottoboni; Farias, Galileu Ferreira; de Moura, Diogo Turiani Hourneaux; Santo, Marco Aurélio; Abu Dayyeh, Barham K; Faria, Caroline Silverio; Antonangelo, Leila; Waitzberg, Dan Linetzki; de Moura, Eduardo Guimarães Hourneaux.
Afiliación
  • Brunaldi VO; Gastrointestinal Endoscopy Unit, Gastroenterology Department, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • Farias GF; General Surgery, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • de Moura DTH; Gastrointestinal Endoscopy Unit, Gastroenterology Department, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • Santo MA; Bariatric Surgery Unit, Gastroenterology Department, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • Abu Dayyeh BK; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States.
  • Faria CS; Lim03, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • Antonangelo L; Pathology Department, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • Waitzberg DL; Gastroenterology Department, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil.
  • de Moura EGH; Gastrointestinal Endoscopy Department, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, Brazil.
Endosc Int Open ; 12(5): E687-E696, 2024 May.
Article en En | MEDLINE | ID: mdl-38812699
ABSTRACT
Background and study aims Transoral outlet reduction (TORe) has long been employed in treating weight regain after Roux-en-Y gastric bypass. However, its impact on gut hormones and their relationship with weight loss remains unknown. Patients and methods This was a substudy of a previous randomized clinical trial. Adults with significant weight regain and dilated gastrojejunostomy underwent TORe with argon plasma coagulation (APC) alone or APC plus endoscopic suturing (APC-suture). Serum levels of ghrelin, GLP-1, and PYY were assessed at fasting, 30, 60, 90, and 120 minutes after a standardized liquid meal. Results were compared according to allocation group, clinical success, and history of cholecystectomy. Results Thirty-six patients (19 APC vs. 17 APC-suture) were enrolled. There were no significant baseline differences between groups. In all analyses, the typical postprandial decrease in ghrelin levels was delayed by 30 minutes, but no other changes were noted. GLP-1 levels significantly decreased at 12 months in both allocation groups. Similar findings were noted after dividing groups according to the history of cholecystectomy and clinical success. The APC cohort presented an increase in PYY levels at 90 minutes, while the APC-suture group did not. Naïve patients had significantly lower PYY levels at baseline ( P = 0.01) compared with cholecystectomized individuals. This latter group experienced a significant increase in area under the curve (AUC) for PYY levels, while naïve patients did not, leading to a higher AUC at 12 months ( P = 0.0001). Conclusions TORe interferes with the dynamics of gut hormones. APC triggers a more pronounced enteroendocrine response than APC-suture, especially in cholecystectomized patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Endosc Int Open Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Endosc Int Open Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Alemania