Transoral outlet reduction: Could additional sutures cause more harm?

Jad Farha, Selim Gebran, Mohamad I. Itani, Cem Simsek, Shahem Abbarh, Ariana Lopez, Zadid Haq, Kristen Koller, Margo Dunlap, Atif Adam, Mouen A. Khashab, Andreas Oberbach, Michael Schweitzer, Dilhana Badurdeen, Vivek Kumbhari

Research output: Contribution to journalArticlepeer-review


Background The double purse-string pattern (DPSP) of transoral outlet reduction (TORe) should conceivably result in a more robust scaffolding for the gastrojejunal anastomosis (GJA). However, there is a paucity of literature pertaining to post-TORe stenosis as an adverse event. Our aim was to determine the rate of stenosis, its potential predictors, and other complications of DPSP TORe. Methods We performed a retrospective analysis of a prospectively maintained database of 129 consecutive patients who underwent DPSP TORe between December 2015 and August 2019. Results The adverse event rate of TORe was 17.1% (n=22), with a 13.3% (n=17) rate of stenosis. Stenosis was not significantly associated with any baseline characteristics. GJA diameter pre- and post-TORe, the difference between these values, and procedure duration were not predictive of stenosis. Of patients who developed stenosis, 10 (58.8%) responded to endoscopic balloon dilation and 7 (41.2%) required stent placement. Conclusion As the DPSP technique is a challenging procedure, with high complication rate and limited benefit, it should not be used for TORe.

Original languageEnglish (US)
Pages (from-to)1059-1064
Number of pages6
Issue number10
StatePublished - Feb 8 2021

ASJC Scopus subject areas

  • Gastroenterology


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