Background:
The double purse-string pattern (DPSP) of transoral outlet reduction (TORe) should conceivably result in a more robust scaffolding for the gastro-jejunal anastomosis (GJA). But there is a paucity of literature pertaining to post-TORe stenosis as an adverse event (AE). Our aim was to determine the rate of stenosis, its potential predictors, and other AEs of the 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 (AER) of TORe was 17.1% (n=22), with a 13.2% (n=17) rate of stenosis. Stenosis was not significantly associated with any baseline characteristics. GJA diameter (GJAD) pre-TORe, procedure duration, GJAD at end-of-TORe, and difference in GJAD between pre-TORe and end-of-TORe, were not predictive of stenosis. Of those that developed stenosis, 10 (58.8%) responded to endoscopic balloon dilation while 7 (41.2%) required stent placement.
Conclusion:
Due to its high AER, the DPSP technique should not be used as the procedure provides no benefit and increased procedure complexity.