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TRANSORAL OUTLET REDUCTION FOR WEIGHT RECIDIVISM AFTER ROUX-EN-Y GASTRIC BYPASS IN PATIENTS OF LOWER SOCIOECONOMIC STATUS
Benjamin Richter
*, Cameron M. Erdman, Mohammed Ayyad, Sameer Rao, Ritik M. Goyal, Lucie Pham, Daniel B. Jones, Danbee Kim, Bao-Ngoc Nasri, Ahmed Al-Khazraji, Kaveh Hajifathalian
Gastroenterology, Rutgers New Jersey Medical School, Newark, NJ
Introduction:
Weight regain after Roux-en-Y gastric bypass (RYGB) is common, especially in patients from lower socioeconomic backgrounds. Transoral Outlet Reduction (TORe) is a minimally invasive procedure in which endoscopic suturing is used to reduce the size of an enlarged gastrojejunal anastomosis after RYGB to facilitate weight loss if weight recidivism or weight loss plataeu occur.
Methods:
This was a cohort study of 6 patients who underwent TORe after RYGB.
Results:
All 6 patients successfully underwent TORe at a median of 12.5 (5.6 - 17.6) years post-RYGB. Patients were all female, with a median age of 55.9 (55.2 - 59.8) years at time of TORe. Four (66.7%) adults identified as Black race, one (16.7%) as other race and two (33.3%) declined to respond; four (66.7%) adults were on Medicaid and two on private insurance (9.1%); median ADI was 9 (8.3 - 8.8). The median body mass index was 33.0 kg/m2 at the time of TORe. Median follow-up after TORe was 8.7 months. Median total body weight loss percent (TBWL%) was 9.3% (3.1% -10.4%) at end of follow-up. Two patients (33%) had repeat TORe, 1 for weight regain and the other for weight loss plateau; the former had TBWL of 3.1% between procedures and was lost to follow up after 2nd TORe, the later had TBWL of 10.42 between procedures with subsequent TBWL of 14.5. Three post-op complications occurred in three adults, including vomiting (n = 3). No complications exceeded grade 1 on the Clavien-Dindo scale.
Conclusion:
TORe is a safe and effective approach to weight recidivism after RYGB in patients of lower SES, although further data is needed on optimal patient selection.
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