GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION
ABSTRACT - BACKGROUND: The twisting of the gastric tube is one of the main causes of persistent reflux and food intolerance after sleeve gastrectomy (SG). To date, there is no classification for gastric twist after SG. OBJECTIVE: This study aimed to propose an endoscopic classification for this co...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2022-06-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100319&tlng=en |
| _version_ | 1811344454235193344 |
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| author | Luciana T. SIQUEIRA Fernando SANTA-CRUZ João Paulo PONTUAL Maria Amélia R. AQUINO Luca T. DOMPIERI Flávio KREIMER Álvaro A. B. FERRAZ |
| author_facet | Luciana T. SIQUEIRA Fernando SANTA-CRUZ João Paulo PONTUAL Maria Amélia R. AQUINO Luca T. DOMPIERI Flávio KREIMER Álvaro A. B. FERRAZ |
| author_sort | Luciana T. SIQUEIRA |
| collection | DOAJ |
| description | ABSTRACT - BACKGROUND: The twisting of the gastric tube is one of the main causes of persistent reflux and food intolerance after sleeve gastrectomy (SG). To date, there is no classification for gastric twist after SG. OBJECTIVE: This study aimed to propose an endoscopic classification for this condition and outline the clinical profile of these patients with sleeve gastrectomy. METHODS: Patients in the postoperative period of SG presenting endoscopic findings of gastric twist were included. All patients underwent an esophagogastroduodenoscopy 12 months after SG. The classification proposed consists of three degrees: degree I: mild rotation of the staple line without relevant shrinkage of the gastric lumen; degree II: moderate rotation of the staple line, leading to a focal area of fixed narrowing that requires additional maneuvers for its transposition; and degree III: severe rotation of the staple line leading to stenosis, with increased difficulty for transposition or complete blockage. RESULTS: Out of 2,723 patients who underwent SG, 45 (1.6%) presented gastric twist. Most patients were female (85%), with mean age of 39±10.4 years. In all, 41 (91.1%) presented degree I, 3 (6.7%) presented degree II, and 1 (2.2%) had degree III. Most patients were asymptomatic (n=26). Vomiting was the most prevalent symptom (15.5%). Statistically significant correlation of twisting degrees was not observed for both the presence of symptoms and the degrees of esophagitis. CONCLUSION: Gastric twist after SG is rare, with generally mild and asymptomatic presentation. The endoscopic classification was not statistically related to clinical presentation but set the ground for further analysis. |
| first_indexed | 2024-04-13T19:47:36Z |
| format | Article |
| id | doaj.art-d872a5c4a8e14dfaa7d1d47276679425 |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-04-13T19:47:36Z |
| publishDate | 2022-06-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-d872a5c4a8e14dfaa7d1d472766794252022-12-22T02:32:41ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202022-06-013510.1590/0102-672020210002e1665GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATIONLuciana T. SIQUEIRAhttps://orcid.org/0000-0001-7970-3689Fernando SANTA-CRUZhttps://orcid.org/0000-0002-3178-1036João Paulo PONTUALhttps://orcid.org/0000-0003-0763-2281Maria Amélia R. AQUINOhttps://orcid.org/0000-0003-1467-4631Luca T. DOMPIERIhttps://orcid.org/0000-0001-9893-4343Flávio KREIMERhttps://orcid.org/0000-0001-6164-9987Álvaro A. B. FERRAZhttps://orcid.org/0000-0002-3832-3927ABSTRACT - BACKGROUND: The twisting of the gastric tube is one of the main causes of persistent reflux and food intolerance after sleeve gastrectomy (SG). To date, there is no classification for gastric twist after SG. OBJECTIVE: This study aimed to propose an endoscopic classification for this condition and outline the clinical profile of these patients with sleeve gastrectomy. METHODS: Patients in the postoperative period of SG presenting endoscopic findings of gastric twist were included. All patients underwent an esophagogastroduodenoscopy 12 months after SG. The classification proposed consists of three degrees: degree I: mild rotation of the staple line without relevant shrinkage of the gastric lumen; degree II: moderate rotation of the staple line, leading to a focal area of fixed narrowing that requires additional maneuvers for its transposition; and degree III: severe rotation of the staple line leading to stenosis, with increased difficulty for transposition or complete blockage. RESULTS: Out of 2,723 patients who underwent SG, 45 (1.6%) presented gastric twist. Most patients were female (85%), with mean age of 39±10.4 years. In all, 41 (91.1%) presented degree I, 3 (6.7%) presented degree II, and 1 (2.2%) had degree III. Most patients were asymptomatic (n=26). Vomiting was the most prevalent symptom (15.5%). Statistically significant correlation of twisting degrees was not observed for both the presence of symptoms and the degrees of esophagitis. CONCLUSION: Gastric twist after SG is rare, with generally mild and asymptomatic presentation. The endoscopic classification was not statistically related to clinical presentation but set the ground for further analysis.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100319&tlng=enBariatric surgeryEndoscopy, GastrointestinalPyloric Stenosis |
| spellingShingle | Luciana T. SIQUEIRA Fernando SANTA-CRUZ João Paulo PONTUAL Maria Amélia R. AQUINO Luca T. DOMPIERI Flávio KREIMER Álvaro A. B. FERRAZ GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION ABCD: Arquivos Brasileiros de Cirurgia Digestiva Bariatric surgery Endoscopy, Gastrointestinal Pyloric Stenosis |
| title | GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION |
| title_full | GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION |
| title_fullStr | GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION |
| title_full_unstemmed | GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION |
| title_short | GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION |
| title_sort | gastric twist after sleeve gastrectomy a proposal for endoscopic classification |
| topic | Bariatric surgery Endoscopy, Gastrointestinal Pyloric Stenosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202022000100319&tlng=en |
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