{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:26:40Z","timestamp":1789075600659,"version":"build-2803163510"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Transoral outlet reduction (TORe), performed using a traditional interrupted or a recently described purse-string suture pattern, is effective at inducing short- and mid-term weight loss in patients with weight regain after Roux-en-Y gastric bypass (RYGB). We aimed to determine the technical feasibility and safety of purse-string TORe and to assess its impact on weight and metabolic profiles. <\/jats:p><jats:p>\n          Patients and methods\u2002RYGB patients undergoing purse-string TORe were included. The gastrojejunal anastomosis (GJA) was ablated using argon plasma coagulation or dissected using endoscopic submucosal dissection. A suture was used to place stitches around the GJA in a continuous ring fashion. The suture was cinched over a balloon (8\u200a\u2013\u200a12\u00a0mm). The primary outcome was technical feasibility. Secondary outcomes were the percentage of total body weight lost (%TWL), adverse events, impact on comorbidities, and predictors of weight loss. <\/jats:p><jats:p>\n          Results\u2002252 RYGB patients underwent 260 purse-string TORes. They had regained 52.6\u200a\u00b1\u200a46.4\u200a% of lost weight and weighed 107.6\u200a\u00b1\u200a24.6\u200akg. The technical success rate was 100\u200a%. At 6 and 12 months, %TWL was 9.6\u200a\u00b1\u200a6.3 and 8.4\u200a\u00b1\u200a8.2.\u200aTwo serious adverse events (0.8\u200a%) occurred: gastrointestinal bleeding and GJA stenosis. At 12 months, blood pressure, hemoglobin A1c, and ALT had improved. Prior weight regain was associated with %TWL at 12 months (\u03b2\u200a=\u200a0.07, P\u200a=\u200a0.007) after controlling for BMI, pouch size, and number of purse-string rings.<\/jats:p><jats:p>\n          Conclusion\u2002Purse-string TORe to treat weight regain after RYGB is technically feasible and safe. Additionally, it is associated with improvement in weight and comorbidity profiles up to 12 months post-procedure. <\/jats:p>","DOI":"10.1055\/s-0043-122380","type":"journal-article","created":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T23:54:09Z","timestamp":1513641249000},"page":"371-377","source":"Crossref","is-referenced-by-count":46,"title":["Purse-string transoral outlet reduction (TORe) is effective at inducing weight loss and improvement in metabolic comorbidities after Roux-en-Y gastric bypass"],"prefix":"10.1055","volume":"50","author":[{"given":"Pichamol","family":"Jirapinyo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kr\u00f6ner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mount Sinai, St. Luke\u2019s and Roosevelt Hospitals, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Thompson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,12,18]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-122380.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T14:23:43Z","timestamp":1546439023000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-122380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,18]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2018,3,27]]},"published-print":{"date-parts":[[2018,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-122380","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,18]]}}}