Transoral outlet reduction: Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice

Table 1 Patient characteristics

Patient Characteristics	Value
Weight at time of RYGB (kg)
mean ± SD	134.2 ± 26.0
Median, range	130.0, 72.7-231.8
Post-RYGB weight nadir (kg)
mean ± SD	79.0 ± 16.3
Median, range	75.0, 51.8-147.7
Weight recurrence from post-RYGB nadir to TORe (%)
mean ± SD	39.5 ± 19.8
Median, range	35.4, 5.3-128
Duration from RYGB to TORe (yr)	13.3 ± 5.8
Weight at time of TORe (kg)
mean ± SD	109.1 ± 20.7
Median, range	106.8, 72.7-171.4
BMI at time of TORe (kg/m2)
mean ± SD	39.3 ± 6.7
Median, range	38.3, 26.5-60.0
Class of obesity at time of TORe, n (%)
Pre-obesity (BMI 25.1-29.9 kg/m2)	8 (2.8)
Class I (BMI 30.0-34.9 kg/m2)	74 (26.1)
Class II (BMI 35.0-39.9 kg/m2)	90 (31.7)
Class III (BMI ≥ 40.0 kg/m2)	112 (39.4%)
No. of female subjects (%)	260 (91.9)
Age at time of TORe (yr)
mean ± SD	51.3 ± 7.9
Median, range	51, 32-72
Obesity-associated medical problems at time of TORe, n (%)
Hypertension	90 (31.7%)
Dyslipidemia	74 (26.1%)
Diabetes, type II	31 (10.9%)
Obstructive sleep apnea	18 (6.3%)

Data are represented as mean ± SD and/or median, range. RYGB: Roux-en-Y gastric bypass; TORe: Transoral outlet reduction; BMI: Body mass index.

Table 2 Procedural characteristics of the transoral outlet reduction, n (%)

Procedural characteristics	Value
Procedure duration (min)	27.5 ± 12.9
Procedure Technique
Purse-string of GJA only	93 (32.7)
Purse-string of GJA + 1 reinforcement suture in pouch	98 (34.5)
Purse-string of GJA + 2 reinforcement sutures in pouch	93 (32.7)
Pre-TORe GJA diameter estimation (mm)
mean ± SD	33.4 ± 6.5
Median, range	35, 20-50
Post-TORe GJA diameter (mm)
mean ± SD	7.6 ± 1.0
Median, range	8, 5-10

Data are represented as mean ± SD and/or median, range. GJA: Gastrojejunal anastomosis; TORe: Transoral outlet reduction.

Table 3 Clinical features of stenosis of the gastrojejunal anastomosis after transoral outlet reduction, n (%)

No. of patients with stenosis	11 (3.9)
Post-TORe GJA diameter (mm)
5	1 (0.35)
6	57 (20)
7	39 (13.7)
8	158 (55.6)
9-10	25 (7.4)
Not reported	4 (1.4)
Post-Stenosis dilation diameter for resolution (mm)
10	6 (54.5)
11	1 (9.1)
12	2 (18.2)
13.5	1 (9.1)
15	1 (9.1)
Days from TORe to symptoms suggestive of stenosis	56.5 ± 30.6
Days from TORe to first endoscopic dilation for stenosis	87.7 ± 60.6
No. of endoscopic dilations to resolve stenosis
1	9 (82)
2	2 (18)
Medical history of patients who developed stenosis
Post-RYGB Stenosis	5 (45.5)
Diabetes, Type II	0
NSAID Use	0
Tobacco use	0

All data is present for the eleven patients who developed gastrojejunal anastomosis stenosis after transoral outlet reduction (TORe), except for days from TORe to symptoms suggestive of stenosis, which were available for ten patients. Data represented as mean ± SD, where appropriate. GJA: gastrojejunal anastomosis; RYGB: Roux-en-Y gastric bypass; NSAID: Non-steroidal anti-inflammatory drug; TORe: Transoral outlet reduction.