Plication transoral outlet reduction effectively treats weight regain after RYGB: Study

This was a registry study of Roux-en-Y gastric bypass (RYGB) patients who underwent Plication transoral outlet reduction (P-TORe) for weight regain. The primary outcome was the amount of weight loss and clinical success rate, defined as per cent total weight loss (%TWL) of at least 5%, at 12 months. Secondary outcomes included technical success, adverse events (AEs) and predictors of weight loss.

The results of the study are:

111 RYGB patients underwent Plication transoral outlet reduction (P-TORe). The average BMI was 38.5±7.5 kg/m2. Baseline GJA and pouch sizes were 17±6 mm and 5±2 cm, respectively. Primary Outcome: At 12 months, patients experienced 9.5±8.5% TWL. The clinical success rate was 73%. Secondary Outcomes: Technical success rate was 100%. Argon plasma coagulation (APC) was performed around the GJA in all patients (100%) prior to plication placement. The total number of plications per case was 7±3. Overall AE rate was 12.6%. These included GJA stenosis (9.9%), melena due to marginal ulceration (1.8%) and deep vein thrombosis (0.9%). The severe AE rate was 0%. Predictors of weight loss where the amount of weight regain and baseline pouch length.

Thus, this novel Plication transoral outlet reduction (P-TORe) technique combining APC with gastric plication appears technically feasible, safe and effective at treating weight regain following RYGB.

Reference:

Endoscopic Gastric Plication for the Treatment of Weight Regain Following Roux-en-Y Gastric Bypass by Pichamol Jirapinyo et al. published in the Gastrointestinal Endoscopy.

DOI: https://doi.org/10.1016/j.gie.2022.02.051