Gastric pouch reduction using StomaphyX in post Roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis.

Goyal, Vinay; Holover, Spencer; Garber, Shawn

BACKGROUND Gastric bypass is the "gold standard" procedure of bariatric surgery. However, 20.4-34.9% of these patients may fail to achieve or maintain the weight loss on long-term follow-up and may require additional procedures. StomaphyX has been promoted for weight reduction in such patients. OBJECTIVES To study whether endoluminal reduction of gastric pouch and stoma using StomaphyX results in sustained weight loss in patients who regain weight after gastric bypass. METHODS Retrospective chart review was performed on 59 postgastric bypass patients who underwent revision of gastric pouch using StomaphyX from 2007 to 2008. Postprocedure weight at 1 week, 1 month, and 6 months follow-up as well as weight at the time of the review was recorded for each patient. RESULTS Average weight loss and excess body weight loss (EBWL) were 2.6 ± 2.3 kg and 7.3 ± 7.1% (n = 42) at 1 week, 3.7 ± 2.9 kg and 11.6 ± 12.1% (n = 31) at 1 month, and 3.8 ± 4.5 kg and 11.5 ± 17.9% (n = 10) at 6 months respectively. At the time of review, the average follow-up was 41 months, average weight loss was 1.7 ± 9.7 kg, and EBWL was 4.3 ± 29.8% (n = 53). Endoscopy in 12 patients at average 18 months follow-up showed no sustained reduction in pouch and stoma size. CONCLUSIONS StomaphyX results in weight loss that is not sustained on long-term follow-up. Pouch and stoma tend to regain their preprocedure size on follow-up. StomaphyX cannot be recommended as a weight loss strategy in postgastric bypass patients who regain weight.