P3175 - Weight Loss after Initial Bariatric Surgery Predicts Early Weight Loss After Revisional Endoscopic Bariatric Therapy

Meghna Yalamanchi, MD¹, Philip Kozan, MD², Sergio A. De La Torre, MD², Danny Issa, MD², Alireza Sedarat, MD², Adarsh Thaker, MD^2
1Olive View-UCLA Medical Center, Los Angeles, CA; ²David Geffen School of Medicine at UCLA, Los Angeles, CA

Introduction: Suboptimal weight loss or weight regain after bariatric surgery is common, previously reported to exceed one-third to one-half of patients who underwent Roux-en-Y Gastric Bypass (RYGB) and sleeve gastrectomy (SG), respectively. Revisional endoscopic bariatric treatments (R-EBTs) including transoral outlet reduction (TORe), transoral outlet reduction with gastroplasty (TORe-G), and revisional endoscopic sleeve gastroplasty (R-ESG) are safe and effective, but factors that predict weight loss after R-EBT remain poorly understood. We aimed to assess whether initial weight loss following bariatric surgery predicted weight loss following R-EBT.

Methods: A retrospective observational study was performed on patients that underwent a R-EBT at an academic tertiary referral center after prior RYGB or sleeve gastrectomy between January 2022 and May 2024. Data was collected on the weight nadir following the index bariatric surgery, patient demographics, and weight loss following EBTs up to 12 months. Weight loss after prior bariatric surgery was compared to weight loss after R-EBT at 6 and 12 months after reintervention. Statistical analysis was performed using a Pearson correlation coefficient.

Results: A total of 59 patients with prior bariatric surgeries underwent R-EBT within our institution, with baseline characteristics included in Table 1. Of the 59 patients, 9 underwent TORe, 28 underwent TORe-G, and 22 underwent R-ESG (Table 1). At the 6-month interval, there was a significant correlation of total body weight loss (TBWL%) between RYGB and TORe (r 0.71, p < 0.05), and TORe-G (r 0.53, p < 0.01). There was a trend towards significance of correlation at 12 months between RYGB and TORe-G (r 0.39, p = 0.059). No correlation was found between weight loss after prior surgical gastric sleeves and after R-ESG (Table 1).

Discussion: Revisional endoscopic bariatric therapies are safe, efficacious, and repeatable treatment options for patients with weight regain or suboptimal weight loss after prior bariatric surgery. Our findings suggest that weight loss after initial RYGB surgery was predictive of early weight loss after R-EBT. This data may help identify patients who may be at risk for suboptimal response to R-EBT and therefore who may warrant more intensive multidisciplinary therapy, such as more aggressive endoscopic techniques, higher intensity diet and lifestyle program, or the addition of weight loss medications.


Disclosures:


Meghna Yalamanchi, MD¹, Philip Kozan, MD², Sergio A. De La Torre, MD², Danny Issa, MD², Alireza Sedarat, MD², Adarsh Thaker, MD². P3175 - Weight Loss after Initial Bariatric Surgery Predicts Early Weight Loss After Revisional Endoscopic Bariatric Therapy, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.