Transoral outlet reduction for the treatment of dumping syndrome after Roux-en-Y gastric bypass: a systematic review and meta-analysis

Gastrointest Endosc. 2026 Mar;103(3):581-585. doi: 10.1016/j.gie.2025.09.036. Epub 2025 Sep 25.

Abstract

Background and aims: Despite the long-term success of Roux-en-Y gastric bypass, dumping syndrome (DS) is one of its significant limitations. Our study aimed to review the effectiveness and safety of transoral outlet reduction (TORe) for DS.

Methods: From inception to May 2024, an individualized search strategy for major databases was developed. The primary and secondary outcomes of our interest were TORe's technical and clinical success rates, periprocedural adverse events, and reintervention rates.

Results: Four studies with 241 patients were included. The pooled technical success rate was 100% (CI 99.08%-100%). The pooled mean Sigstad score difference calculated before and after the procedure was 13.13 (CI 11.90-15.56; P < .01), reflecting clinical success. The pooled periprocedural adverse event rate was 10.46% (CI 0.42%-28.30%) and the pooled reintervention rate was 7.99% (CI 1.46%-18.05%).

Conclusions: Our study concludes that TORe is an effective and safe procedure for treating DS among patients who undergo Roux-en-Y gastric bypass.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Dumping Syndrome* / etiology
  • Dumping Syndrome* / surgery
  • Gastric Bypass* / adverse effects
  • Humans
  • Natural Orifice Endoscopic Surgery* / methods
  • Postoperative Complications* / etiology
  • Postoperative Complications* / surgery
  • Reoperation / statistics & numerical data
  • Treatment Outcome