How Taking into Account the Pyloric Tonus Contributes to Treatment Success While Administering Gastric "Botulinum Toxin A" for Weight Loss
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Purpose To analyze how considering the structure of normotonic pylorus (NP) or hypotonic pylorus (HP) contributes to treatment success in patients administered gastric botulinum toxin A for weight loss. Materials and Methods We measured body mass indexes (BMIs) of the patients who applied for gastric botulinum toxin A (BTA) for weight loss, before and 6 months after the procedure. The patients' pylori were classified as normotonic pylorus (NP) if, during endoscopy, they had a normal peristaltic motion and was closing completely, and as hypotonic pylorus if they were not closing properly or were aperistaltic. We compared the patients' mean pre-operative and 6-month post-operative BMIs. The groups were compared using the chi-square test where a p < 0.05 was considered significant. Results The study included 178 patients administered gastric BTA. In the assessment made without considering the pyloric structure, the mean BMI decreased from 34.76 +/- 7.65 to 33.09 +/- 7.80 kg/m(2), while the difference was not statistically significant (p < 0.06). Conversely, in the analysis performed considering the structure of pylorus, the mean pre-operative BMI of the 45 patients with HP structure was 35.16 +/- 7.07 kg/m(2) which decreased to 35.11 +/- 7.03 kg/m(2) 6 months after the procedure; hence, the difference was not statistically significant (p < 0.7). The mean pre-operative BMI of the 133 patients with NP structure, 34.63 +/- 7.84 kg/m(2), decreased to 32.40 +/- 8.05 kg/m(2) 6 months after the procedure and the difference was statistically significant (p < 0.05)*. Conclusion We advise to be selective in BTA administration and to administer BTA to the patients who, endoscopically, have a NP structure.
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