P4465 - Efficacy of Endoscopic Transoral Outlet Reduction (TORe) on Weight Loss Outcomes in Diabetic vs Non-Diabetic Patients Following Roux-en-Y Gastric Bypass

Elizza E. Villarruel, BS¹, Philip Kozan, MD², Ruvimbo Dzvurumi, BS², Fadi Dahoud, BS², Norman Spivak, BS², Diego Cisneros, BS², Manar Alhanaee, MD², Sagar Shah, MD², Firas Bahdi, MD², Alireza Sedarat, MD², Stephen Kim, 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: Roux-en-Y gastric bypass (RYGB) is considered an effective long-term management of morbid obesity; however, a large proportion of patients experience weight regain. Endoscopic bariatric therapies (EBTs), specifically transoral outlet reduction (TORe) with gastroplasty (TORe-G) have emerged as a therapeutic option for weight loss in this group of patients. Based on previous surgical literature, patients with diabetes undergoing bariatric surgery experience less weight loss compared to non-diabetics. There is limited data regarding the efficacy of TORe in patients with and without diabetes. We aimed to assess if the impact of diabetes on weight loss outcomes in patients undergoing EBTs with a history of RYGB.

Methods: A retrospective observational study was performed on a prospectively maintained registry of patients with a history of bariatric surgery who underwent TORe at an academic tertiary-care referral center between Jan 2018 and Oct 2023. Inclusion criteria were patients with and without diabetes who had weight regain after RYGB, defined as ≥25% weight gain from nadir and underwent an EBT. Data collected included diabetes status, patient demographics, comorbidities, procedural characteristics, and weight loss data. The primary outcome was the percent total body weight loss (%TBWL) at 3-, 6-, and 12-months following index EBT.

Results: A total of 48 patients with prior RYGB underwent TORe/TORe-G for weight regain, with 25% of patients having a history of diabetes. There was no significant difference in demographics, comorbidities or baseline BMI between the two groups (Table 1). Patients undergoing TORe-G had a significantly higher %TBWL at three months than those undergoing standard TORe (p = 0.011). Still, there was no significant difference in %TBWL at 6 and 12 months (Table 1). At all time intervals, 3-, 6-, and 12-months post EBT, there was no significant difference in weight loss based on diabetes status, further described in figure 1.

Discussion: This study shows that the efficacy of TORe for the treatment of weight regain post-RYGB is similar in diabetic and non-diabetic patients during a 12 months follow-up period. Nevertheless, TORe with gastroplasty might be more effective than TORe alone.



Disclosures:


Elizza E. Villarruel, BS¹, Philip Kozan, MD², Ruvimbo Dzvurumi, BS², Fadi Dahoud, BS², Norman Spivak, BS², Diego Cisneros, BS², Manar Alhanaee, MD², Sagar Shah, MD², Firas Bahdi, MD², Alireza Sedarat, MD², Stephen Kim, MD², Adarsh Thaker, MD², Venkataraman R. Muthusamy, MD³, Danny Issa, MD². P4465 - Efficacy of Endoscopic Transoral Outlet Reduction (TORe) on Weight Loss Outcomes in Diabetic vs Non-Diabetic Patients Following Roux-en-Y Gastric Bypass, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.