Imperial College London
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Dr Alex Miras

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Visiting Professor
 
 
 
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Contact

 

+44 (0)7958 377 674a.miras

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kamocka:2020:10.1007/s00464-019-06988-4,
author = {Kamocka, A and McGlone, ER and Pérez-Pevida, B and Moorthy, K and Hakky, S and Tsironis, C and Chahal, H and Miras, AD and Tan, T and Purkayastha, S and Ahmed, AR},
doi = {10.1007/s00464-019-06988-4},
journal = {Surgical Endoscopy},
pages = {2076--2081},
title = {Candy cane revision after Roux-en-Y gastric bypass},
url = {http://dx.doi.org/10.1007/s00464-019-06988-4},
volume = {34},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: An excessively long-blind end of the alimentary limb following a Roux-en-Y gastric bypass (RYGB), known as a 'candy cane' (CC), may cause symptoms including abdominal pain, regurgitation and vomiting. Very few studies have examined the efficacy of surgical resection of the CC. OBJECTIVES: The aim of this study was to assess sensitivity of preoperative diagnostic tools for CC, as well as perioperative outcomes and symptom resolution after CC revision surgery. SETTING: High volume bariatric centre of excellence, United Kingdom. METHODS: Observational study of CC revisions from 2010 to 2017. RESULTS: Twenty-eight CC revision cases were identified (mean age 45 ± 9 years, female preponderance 9:1). Presenting symptoms were abdominal pain (86%), regurgitation/vomiting (43%), suboptimal weight loss (36%) and acid reflux (21%). Preoperative tests provided correct diagnosis in 63% of barium contrast swallows, 50% of upper gastrointestinal endoscopies and 29% computed tomographies. Patients presenting with pain had significantly higher CC size as compared with pain-free group (4.2 vs. 2 cm, p = 0.001). Perioperative complications occurred in 25% of cases. Complete or partial symptom resolution was documented in 73% of patients undergoing CC revision. Highest success rates were recorded in the regurgitation/vomiting group (67%). CONCLUSION: Surgical revision of CC is associated with good symptom resolution in the majority of patients, especially those presenting with regurgitation/vomiting. However, it carries certain risk of complications. CC diagnosis may frequently be missed; hence more than one diagnostic tool should be considered when investigating symptomatic patients after RYGB.
AU  - Kamocka,A
AU  - McGlone,ER
AU  - Pérez-Pevida,B
AU  - Moorthy,K
AU  - Hakky,S
AU  - Tsironis,C
AU  - Chahal,H
AU  - Miras,AD
AU  - Tan,T
AU  - Purkayastha,S
AU  - Ahmed,AR
DO  - 10.1007/s00464-019-06988-4
EP  - 2081
PY  - 2020///
SN  - 0930-2794
SP  - 2076
TI  - Candy cane revision after Roux-en-Y gastric bypass
T2  - Surgical Endoscopy
UR  - http://dx.doi.org/10.1007/s00464-019-06988-4
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31392513
UR  - http://hdl.handle.net/10044/1/72545
VL  - 34
ER  -
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