P2784 - Efficacy of Transoral Outlet Reduction for Weight Regain Following Roux-en Y Gastric Bypass: A Comparison of Pre and Post COVID-19 Pandemic

Elizza E. Villarruel, BS¹, Fadi Dahoud, BS², Norman Spivak, BS², Manar Alhanaee, MD², Stephen Kim, MD², Ronald Omino, MD², Shahrad Hakimian, MD², Alireza Sedarat, MD², Adarsh Thaker, MD², Venkataraman R. Muthusamy, MD³, 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 following Roux-en Y gastric bypass (RYGB) is a common problem that has increased since the COVID-19 pandemic. The impact of the pandemic on endoscopic revisional therapy in bariatric patients is unknown. This study aimed to 1) analyze a large cohort of patients who underwent transoral outlet reduction (TORe) for weight regain after RYGB and 2) compare the efficacy of TORe before and after the COVID-19 pandemic.

Methods: We conducted a retrospective study using a prospectively maintained database of bariatric patients at a large tertiary-care referral center. Inclusion criteria were adult patients with significant weight regain following RYGB, defined as ≥25% weight gain from nadir, undergoing TORe procedure between January 2018 and October 2023. Outcomes included change in HbA1c, BMI reduction and percent total body weight loss (%TBWL) at 3, 6, and 12 months. Outcomes were compared between the groups using the Bonferroni test and generalized estimating equations.

Results: 92 RYGB patients underwent TORe for treatment of weight regain. Among those, 26 (28.3%) had TORe before the COVID-19 pandemic (group A), and 66 (71.7%) after the pandemic (group B). There was no significant difference in patients' age, gender, or ethnicity between the two groups. Baseline BMI was similar between groups A (39 ± 7.6 kg/m2) and B (39.7 ± 6.5 kg/m2); P=0.17. At six months, the proportion of patients who achieved ≥ 10%TBWL was higher in the post-pandemic group compared to the pre-pandemic group (57.7% vs. 42.9%, P< 0.05). Comparing weight loss between groups A and B: TORe lead to mean %TBWL of (9.0 ± 6.4 vs. 10.3 ± 4.6, P=0.40) at three months, %TBWL of (6.7 ± 6.3 vs. 10.5 ± 6.9, P=0.15) at six months, and %TBWL (6.4 ± 6.1 vs. 8.8 ± 8.8, P=0.42) at 12 months, respectively. Improvements in HbA1c were similar (-0.18 ± 0.5 in group A vs. -0.39 ± 0.5 in group B, P=0.2).

Discussion: In our cohort, there was a notable difference of TORe achieving weight loss between the pre-pandemic and post-pandemic groups- particularly the proportion of patients achieving ≥ 10%TBWL at six months (P< 0.05). Although the mean %TBWL was higher in the post-pandemic group at each period (3, 6, and 12 months), the differences were not statistically significant. While the data suggests there is an improvement in outcomes in the post-pandemic group, further studies with larger sample sizes are needed to validate these findings.



Disclosures:


Elizza E. Villarruel, BS¹, Fadi Dahoud, BS², Norman Spivak, BS², Manar Alhanaee, MD², Stephen Kim, MD², Ronald Omino, MD², Shahrad Hakimian, MD², Alireza Sedarat, MD², Adarsh Thaker, MD², Venkataraman R. Muthusamy, MD³, Danny Issa, MD². P2784 - Efficacy of Transoral Outlet Reduction for Weight Regain Following Roux-en Y Gastric Bypass: A Comparison of Pre and Post COVID-19 Pandemic, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.