Endoscopic Dilation of Bariatric RNY Anastomotic Strictures: a Systematic Review and Meta-analysis

Alexandra J. Baumann; Lazarus Katana Mramba; Russell B. Hawkins; Anne Marie Carpenter; Max S. Fleisher; Alexander L. Ayzengart; David S. Estores

doi:10.1007/s11695-018-3491-6

Endoscopic Dilation of Bariatric RNY Anastomotic Strictures: a Systematic Review and Meta-analysis

Alexandra J. Baumann, Lazarus Katana Mramba, Russell B. Hawkins, Anne Marie Carpenter, Max S. Fleisher, Alexander L. Ayzengart, David S. Estores^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

8 Scopus citations

Abstract

Gastrojejunostomy anastomotic strictures are a complication of Roux-en-Y gastric bypass surgery without an established treatment guideline. A systematic review and meta-analysis were performed to determine the safety and efficacy of endoscopic dilation in their management. PubMed, Web of Science, and Cochrane Central (1994–2017) were searched. Data was analyzed with random effects meta-analysis and mixed effects meta-regression. Twenty-one observational studies (896 patients) were included. The stricture rate for laparoscopic patients was 6% (95% CI, 5–9%). Only 38% (95% CI, 30–47%) required greater than one dilation. Symptom improvement occurred in 97% (95% CI, 94–98%). The complication rate was 4% (95% CI, 3–6%). Endoscopic dilation of GJA strictures is safe, effective, and sustaining. This study can guide endoscopists in the treatment of a common bariatric surgical complication.

Original language	English (US)
Pages (from-to)	4053-4063
Number of pages	11
Journal	Obesity Surgery
Volume	28
Issue number	12
DOIs	https://doi.org/10.1007/s11695-018-3491-6
State	Published - Dec 1 2018
Externally published	Yes

Keywords

Adults
Anastomosis, Roux-en-Y
Anastomosis, surgical/adverse effects
Constriction, Pathologic/etiology/therapy
Endoscopy, gastrointestinal
Humans

ASJC Scopus subject areas

Surgery
Endocrinology, Diabetes and Metabolism
Nutrition and Dietetics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s11695-018-3491-6

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title = "Endoscopic Dilation of Bariatric RNY Anastomotic Strictures: a Systematic Review and Meta-analysis",

abstract = "Gastrojejunostomy anastomotic strictures are a complication of Roux-en-Y gastric bypass surgery without an established treatment guideline. A systematic review and meta-analysis were performed to determine the safety and efficacy of endoscopic dilation in their management. PubMed, Web of Science, and Cochrane Central (1994–2017) were searched. Data was analyzed with random effects meta-analysis and mixed effects meta-regression. Twenty-one observational studies (896 patients) were included. The stricture rate for laparoscopic patients was 6% (95% CI, 5–9%). Only 38% (95% CI, 30–47%) required greater than one dilation. Symptom improvement occurred in 97% (95% CI, 94–98%). The complication rate was 4% (95% CI, 3–6%). Endoscopic dilation of GJA strictures is safe, effective, and sustaining. This study can guide endoscopists in the treatment of a common bariatric surgical complication.",

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T2 - a Systematic Review and Meta-analysis

AU - Baumann, Alexandra J.

AU - Mramba, Lazarus Katana

AU - Hawkins, Russell B.

AU - Carpenter, Anne Marie

AU - Fleisher, Max S.

AU - Ayzengart, Alexander L.

AU - Estores, David S.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Gastrojejunostomy anastomotic strictures are a complication of Roux-en-Y gastric bypass surgery without an established treatment guideline. A systematic review and meta-analysis were performed to determine the safety and efficacy of endoscopic dilation in their management. PubMed, Web of Science, and Cochrane Central (1994–2017) were searched. Data was analyzed with random effects meta-analysis and mixed effects meta-regression. Twenty-one observational studies (896 patients) were included. The stricture rate for laparoscopic patients was 6% (95% CI, 5–9%). Only 38% (95% CI, 30–47%) required greater than one dilation. Symptom improvement occurred in 97% (95% CI, 94–98%). The complication rate was 4% (95% CI, 3–6%). Endoscopic dilation of GJA strictures is safe, effective, and sustaining. This study can guide endoscopists in the treatment of a common bariatric surgical complication.

AB - Gastrojejunostomy anastomotic strictures are a complication of Roux-en-Y gastric bypass surgery without an established treatment guideline. A systematic review and meta-analysis were performed to determine the safety and efficacy of endoscopic dilation in their management. PubMed, Web of Science, and Cochrane Central (1994–2017) were searched. Data was analyzed with random effects meta-analysis and mixed effects meta-regression. Twenty-one observational studies (896 patients) were included. The stricture rate for laparoscopic patients was 6% (95% CI, 5–9%). Only 38% (95% CI, 30–47%) required greater than one dilation. Symptom improvement occurred in 97% (95% CI, 94–98%). The complication rate was 4% (95% CI, 3–6%). Endoscopic dilation of GJA strictures is safe, effective, and sustaining. This study can guide endoscopists in the treatment of a common bariatric surgical complication.

KW - Adults

KW - Anastomosis, Roux-en-Y

KW - Anastomosis, surgical/adverse effects

KW - Constriction, Pathologic/etiology/therapy

KW - Endoscopy, gastrointestinal

KW - Humans

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ER -

Endoscopic Dilation of Bariatric RNY Anastomotic Strictures: a Systematic Review and Meta-analysis

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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