Luiz Gustavo de Quadros1,2,3,4, Daniela Coca Germany Faria5, Manoel Galvão Neto6,7, Vitor Brunaldi8, Idiberto José Zotarelli Filho9, Mikaell Alexandre Gouvêa Faria5, Eduardo Grecco6,7,10, Mario Flamini Junior5, Sâmara Fernandes Santos Martins11, André Teixeira12, Cinthia Barbosa de Andrade13, Alvaro Antonio Bandeira Ferraz13, Roberto Luiz Kaiser Junior14,5. 1. Beneficencia Portuguesa Hospital, São Jose Do Rio Preto, Brazil. Gustavo_quadros@hotmail.com. 2. Faculty of Medicine of ABC, Santo André, Brazil. Gustavo_quadros@hotmail.com. 3. Faculty of Medicine of São José do Rio Preto, FAMERP, São José do Rio Preto, Brazil. Gustavo_quadros@hotmail.com. 4. Kaiser Clinic, Street XV de Novembro, 3975, Redentora, Sao Jose Do Rio Preto, SP, CEP 15015-110, Brazil. Gustavo_quadros@hotmail.com. 5. Kaiser Clinic, Street XV de Novembro, 3975, Redentora, Sao Jose Do Rio Preto, SP, CEP 15015-110, Brazil. 6. Faculty of Medicine of ABC, Santo André, Brazil. 7. Endovitta Institute, São Paulo, Brazil. 8. Center of Gastrointestinal Endoscopy, Surgery and Anatomy Department, Ribeirao Preto Faculty of Medicine, University of Sao Paulo, Ribeirão Preto, Brazil. 9. Faculty of Medicine FACERES, São José Do Rio Preto, Brazil. 10. University of Sao Caetano Do Sul, São Caetano do Sul, Brazil. 11. Mario Covas Hospital, São Paulo, Brazil. 12. Orlando Health, Orlando, FL, USA. 13. Universidade Federal de Pernambuco, Recife, Brazil. 14. Faculty of Medicine of São José do Rio Preto, FAMERP, São José do Rio Preto, Brazil.
Abstract
PURPOSE: Banded Roux-en-Y gastric bypass (RYGB) was a common bariatric procedure in the 2000s, and the ring slippage is one of its late adverse events. Both plastic and metallic stents have been reported as adjunct methods to induce erosion and facilitate endoscopic removal of the ring. OBJECTIVE: To compare the safety and effectiveness of self-expanding metallic stents (SEMS) and plastic stents (SEPS) to treat ring slippage. MATERIALS AND METHODS: We conducted a retrospective longitudinal study analyzing consecutive patients with ring dysfunction treated with stents plus endoscopic removal. RESULTS: Ninety patients were enrolled (36 SEMS vs. 54 SEPS). The mean age was 48.56 ± 13.07 and 45.6 ± 12.1 in the SEMS and SEPS groups, respectively. All patients had band slippage, but 24 from SEMS group and 23 from SEPS group had further complications. There were more complications in metallic stent concerning mean absolute number of therapy-related adverse events (1.33 ± 0.48 vs. 1.72 ± 0.5, p > 0.05) and time until erosion (14.9 ± 1.6 vs. 13.8 ± 1.4 days, p > 0.05). Female sex and age > 41 years old correlated with longer time to band erosion and higher incidence of adverse events in SEMS patients. In SEPS group, only female sex was a risk factor for adverse events. CONCLUSION: Both procedures were efficient at inducing band erosion with similar safety profiles. Older and female patients are at a higher risk of treatment-related adverse events, especially those receiving SEMS.
PURPOSE: Banded Roux-en-Y gastric bypass (RYGB) was a common bariatric procedure in the 2000s, and the ring slippage is one of its late adverse events. Both plastic and metallic stents have been reported as adjunct methods to induce erosion and facilitate endoscopic removal of the ring. OBJECTIVE: To compare the safety and effectiveness of self-expanding metallic stents (SEMS) and plastic stents (SEPS) to treat ring slippage. MATERIALS AND METHODS: We conducted a retrospective longitudinal study analyzing consecutive patients with ring dysfunction treated with stents plus endoscopic removal. RESULTS: Ninety patients were enrolled (36 SEMS vs. 54 SEPS). The mean age was 48.56 ± 13.07 and 45.6 ± 12.1 in the SEMS and SEPS groups, respectively. All patients had band slippage, but 24 from SEMS group and 23 from SEPS group had further complications. There were more complications in metallic stent concerning mean absolute number of therapy-related adverse events (1.33 ± 0.48 vs. 1.72 ± 0.5, p > 0.05) and time until erosion (14.9 ± 1.6 vs. 13.8 ± 1.4 days, p > 0.05). Female sex and age > 41 years old correlated with longer time to band erosion and higher incidence of adverse events in SEMS patients. In SEPS group, only female sex was a risk factor for adverse events. CONCLUSION: Both procedures were efficient at inducing band erosion with similar safety profiles. Older and female patients are at a higher risk of treatment-related adverse events, especially those receiving SEMS.
Authors: Josemberg Marins Campos; Rena C Moon; Galeno E J Magalhães Neto; Andre F Teixeira; Muhammad A Jawad; Lyz Bezerra Silva; Manoel Galvão Neto; Álvaro Antônio B Ferraz Journal: Endoscopy Date: 2016-03-16 Impact factor: 10.093