How Taking into Account the Pyloric Tonus Contributes to Treatment Success While Administering Gastric "Botulinum Toxin A" for Weight Loss

Abstract

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.