title: Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass.
abstract: OBJECTIVE
  Weight regain after Roux-en-Y gastric bypass (RYGB) is associated with reductions in health status and quality of life. We evaluated whether gastrojejunal stoma diameter is a risk factor for weight regain after RYGB.
  
  
  METHODS
  We examined data collected over 4 years from consecutive patients referred to a tertiary care bariatric center for upper endoscopy after RYGB. We used linear regression analysis to determine the association between the gastrojejunal stoma diameter and weight regain. We applied a logistic regression model using clinical and endoscopic parameters to develop a prediction rule for weight gain after RYGB.
  
  
  RESULTS
  Among 165 patients included in our study, 59% had significant weight regain (≥ 20% of maximum weight lost after the RYGB) and 41% did not. The mean percentage of maximal weight lost after RYGB that was regained in the entire cohort was 30% ± 22%. Gastrojejunal stoma diameter was associated significantly with weight regain after RYGB surgery in univariate analysis (β = .31, P < .0001). This association remained significant after adjusting for several known or purported risk factors for weight regain (β = .19, P = .003). We developed a simple prediction rule for weight regain after RYGB using a 7-point scoring system that includes the gastrojejunal stoma diameter, race, and percentage of maximal body weight lost after RYGB; a cut-off score of 4 or more points had an area under receiver operating characteristic curve of 0.76 and a positive predictive value of 75%.
  
  
  CONCLUSIONS
  Increased gastrojejunal stoma diameter is a risk factor for weight regain after RYGB and can be incorporated in a novel prediction rule.
authors.affiliation: Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Barham K
authors.initials: BK
authors.lastname: Abu Dayyeh
authors.forename: David B
authors.initials: DB
authors.lastname: Lautz
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Thompson
mesh_terms: D000328:Adult; D016099:Endoscopy, Gastrointestinal; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007583:Jejunum / Q000033:anatomy & histology* / Q000473:pathology; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000517:prevention & control* / Q000601:surgery; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment; D013223:Statistics as Topic; D013270:Stomach / Q000033:anatomy & histology* / Q000473:pathology; D015430:Weight Gain