Gastroenterology Service Intesto, 3012 Bern, Switzerland.
Gastroenterology Service Intesto, Hôpital Fribourgeois, University of Fribourg, 1700 Fribourg, Switzerland.
Medicina (Kaunas). 2023 Jan 8;59(1):125. doi: 10.3390/medicina59010125.
Obesity is a chronic relapsing disease of global pandemic proportions. In this context, an increasing number of patients are undergoing bariatric surgery, which is considered the most effective weight loss treatment for long-term improvement in obesity-related comorbidities. One of the most popular bariatric surgeries is the Roux-en-Y gastric bypass (RYGB). Despite its proven short- and long-term efficacy, progressive weight regain and dumping symptoms remain a challenge. Revisional bariatric surgery is indicated when dietary and lifestyle modification, pharmaceutical agents and/or psychological therapy fail to arrest weight regain or control dumping. However, these re-interventions present greater technical difficulty and are accompanied by an increased risk of peri- and postoperative complications with substantial morbidity and mortality. The endoscopic approach to gastrojejunal anastomotic revision, transoral outlet reduction (TORe), is used as a minimally invasive treatment that aims to reduce the diameter of the gastrojejunal anastomosis, delaying gastric emptying and increasing satiety. With substantial published data supporting its use, TORe is an effective and safe bariatric endoscopic technique for addressing weight regain and dumping syndrome after RYGB.
肥胖是一种具有全球流行程度的慢性复发性疾病。在这种情况下，越来越多的患者正在接受减肥手术，该手术被认为是治疗肥胖相关并发症的最有效方法，可以长期改善这些并发症。减肥手术中最受欢迎的一种是 Roux-en-Y 胃旁路术（RYGB）。尽管其短期和长期疗效已得到证实，但体重逐渐恢复和倾倒症状仍然是一个挑战。当饮食和生活方式改变、药物治疗和/或心理治疗未能阻止体重恢复或控制倾倒时，需要进行减肥手术修正。然而，这些再次干预具有更大的技术难度，并伴随着围手术期并发症风险增加，具有较高的发病率和死亡率。胃空肠吻合口修正的内镜方法，经口输出道缩小术（TORe），是一种微创治疗方法，旨在缩小胃空肠吻合口的直径，延迟胃排空并增加饱腹感。大量已发表的数据支持其使用，TORe 是一种有效的、安全的减肥内镜技术，可用于解决 RYGB 后体重恢复和倾倒综合征。
