P1072 - Predicting Factors of Higher Weight Loss After Endoscopic Transoral Outlet Reduction (TORe) in a Large Cohort of Bariatric Patients

Elizza E. Villarruel, BS¹, Fadi Dahoud, BS², Ruvimbo Dzvurumi, BS², Norman Spivak, BS², Firas Bahdi, MD², Maryam Farooq, BS², Basak Kanlilar-Ruiz, NP², Manar Alhanaee, MD², Stephen Kim, MD², Alireza Sedarat, MD², Venkataraman R. Muthusamy, MD³, Adarsh Thaker, MD², Danny Issa, MD^2
1David Geffen School of Medicine at UCLA, La Puente, CA; ²David Geffen School of Medicine at UCLA, Los Angeles, CA; ³David Geffen School of Medicine at UCLA, Sherman Oaks, CA

Introduction: Weight regain is a common complication following roux-en y gastric bypass (RYGB). While endoscopic transoral outlet reduction (TORe) is a safe and effective treatment for weight regain post RYGB, data on the factors predicting higher procedural efficacy is limited to a few centers and small studies. This study aimed to 1) analyze a cohort of patients who underwent TORe for weight regain within the last five years and 2) evaluate factors that influence higher total body weight loss (TBWL) following TORe.

Methods: A retrospective study was conducted using a prospectively maintained database of bariatric patients followed for five years (2018-2023) at a large tertiary-care referral center. Inclusion criteria were adult patients who experienced weight regain after RYGB, defined as ≥25% weight gain from nadir, and who underwent TORe. Patients underwent TORe (pursestring suturing or APC only), or TORe + gastroplasty (TORe-G). Demographic and procedural variables were collected. Primary outcomes were factors that predicted >5% and >10% TBWL after TORe. Secondary outcomes included %TBWL at 3, 6, and 12 months after TORe.

Results: A total of 90 RYGB patients who underwent TORe (mean age 52.4 ± 9.9, baseline BMI: 39.6 ± 6.9) were evaluated. 49(54.4%) patients underwent TORe, whereas 41 (45.6%) underwent TORe-G. Logistic regression analysis showed two primary predictors of higher weight loss. Pouch dilation was associated with a greater percentage of patients who achieved >10% weight loss (P=0.011) at 6 months post TORe. Similarly, higher pouch size >6cm was associated with a greater >10% weight loss (P=0.008) at 6 months post TORe-G. After adjusting for size/pouch diameters, no difference was found in %TBWL between the TORe and TORe-G. Pouch diameter showed a trend towards greater 10% weight loss at 12 months, but no significance (p=0.066). A trend was observed towards >5% weight loss at 12 months in patients treated post-COVID-19 pandemic compared to pre-pandemic (p = 0.087).

Discussion: The study highlights that dilated pouch diameter and increased pouch size in RYGB patients with weight regain predict higher percentage of weight loss after TORe. Long-term weight loss outcomes are less predictable using these measures.


Disclosures:


Elizza E. Villarruel, BS¹, Fadi Dahoud, BS², Ruvimbo Dzvurumi, BS², Norman Spivak, BS², Firas Bahdi, MD², Maryam Farooq, BS², Basak Kanlilar-Ruiz, NP², Manar Alhanaee, MD², Stephen Kim, MD², Alireza Sedarat, MD², Venkataraman R. Muthusamy, MD³, Adarsh Thaker, MD², Danny Issa, MD². P1072 - Predicting Factors of Higher Weight Loss After Endoscopic Transoral Outlet Reduction (TORe) in a Large Cohort of Bariatric Patients, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.