Efficacy of argon plasma coagulation (APC) in the reduction of gastrojejunal anastomosis for weight regain after Roux-en-Y gastric bypass

BACKGROUND & AIMS Argon plasma coagulation (APC) is effective in the reduction of gastrojejunal anastomosis (GJA) for weight regain after Roux-en-Y gastric bypass (RYGB). This study aims to confirm the efficacy of APC in treating weight regain following RYGB surgery and to analyse factors associated with treatment success. PATIENTS AND METHODS Single-center retrospective study of 36 RYGB patients who underwent APC for weight regain from 2018 to 2023. Percentage total weight loss (%TWL) was analyzed as the primary outcome and reduction in anastomosis diameter (RAD), comorbidities, and adverse events (AE) were evaluated as secondary outcomes. Patients were classified according to %TWL categories of ≥5%, ≥10% or ≥15% and were followed up at 3, 6 and 12 months. Patients with ≥5% TWL at 3 months were considered responders. The relationship between %TWL and age, sex, changes in BMI and comorbidities was analyzed. RESULTS Over 60% of patients lost ≥5% TWL at 3, 6 and 12 months, with no statistical association with RAD. TWL for responders was 14,9%, 11,7% and 11,1% at 3, 6, 12 months respectively with statistical differences compared to non-responders. No clinically significant associations were found between pre-treatment factors and subsequent weight loss. At 12 months, over 80% of patients maintained ≥5% of TWL, and over half achieved a TWL of ≥10%. Mean BMI in responders was 31.68 ± 0.1; and over a quarter (27.3%) of them achieved a final BMI of less than 30, which could be considered a significant success, as these patients would no longer be classifed as obese. Technical success was 100%. Only 3(8%) AEs were registered, withmild anastomotic stenosis occuring most commonly. CONCLUSIONS: APC is a simple and effective technique for inducing weight loss after RYGB, with beneficial results observed in at least 60% of patients in this study.