Background and Aims
Questions related to the safety and long-term efficacy of endoscopic sleeve gastroplasty
(ESG) are not yet answered. Here we report weight loss, morbidity, revisions, and
comorbidity resolution during the first 18 months after primary ESG.
Methods
This is a consecutive case series from a prospective observational study executed
in a specialized center with a standardized pathway for multimodal management of obesity.
Results
The 1000 patients in this study had a baseline body mass index of 33.3 ± 4.5 kg/m2 and age of 34.4 ± 9.5 years. Eight hundred ninety-seven patients (89.7%) were women.
Mean percentage of total weight loss at 6, 12, and 18 months was 13.7% ± 6.8% (n =
369; follow-up rate = 423; 87.2%), 15.0% ± 7.7% (n = 216; follow-up rate = 232; 93.1%),
and 14.8% ± 8.5% (n = 54; follow-up rate = 63; 85.7%), respectively. Lost to follow-up
at the 12- and 18-month visits were 6.9% and 14.3%, respectively. Thirteen of 17 cases
of diabetes, all 28 cases of hypertension, and 18 of 32 cases of dyslipidemia were
in complete remission by the third month. With regard to postoperative complaints,
924 patients (92.4%) complained of nausea or abdominal pain that was controlled with
medications during the first week after ESG. Twenty-four patients were readmitted:
8 for severe abdominal pain, of whom 3 had ESG reversal; 7 for postprocedure bleeding,
2 of whom received 2 units of packed red blood cells each; 4 for perigastric collection
with pleural effusion, 3 of whom underwent percutaneous drainage; and 5 for postprocedure
fever with no sequelae. Eight patients were revised to sleeve gastrectomy, and 5 had
redo-ESG. No patient required an emergency intervention, and there were no mortalities.
Conclusions
ESG appears to be well tolerated, safe, and effective. Significant weight loss occurs
during the first 18 months without mortality or significant morbidity. Some patients
require revision or reversal during the first year.
Graphical abstract
Graphical Abstract
Abbreviations:
ED (emergency department), ESG (endoscopic sleeve gastroplasty), %TWL (percentage of total weight lost)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 19, 2018
Accepted:
December 9,
2018
Received:
August 28,
2018
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 1241.
If you would like to chat with an author of this article, you may contact Dr Alqahtani at [email protected]
Identification
Copyright
© 2019 by the American Society for Gastrointestinal Endoscopy
ScienceDirect
Access this article on ScienceDirectLinked Article
- Endoscopic sleeve gastroplasty for obesity: defining the risk and reward after more than 1600 proceduresGastrointestinal EndoscopyVol. 89Issue 6
- PreviewIn response to the obesity epidemic, rates of bariatric surgery have increased, particularly laparoscopic sleeve gastrectomy, which is now the most commonly performed bariatric surgery worldwide. Laparoscopic sleeve gastrectomy excises the greater curvature of the stomach, resulting in a restricted tubular reservoir approximately 25% of its native volume. Although technically simple, safe, and effective for weight loss, sleeve gastrectomy is associated with increased health care utilization costs secondary to multiple known serious adverse events (SAEs), and increased prevalence of worsened or de novo GERD with unknown associated long-term risks of Barrett’s esophagus and esophageal adenocarcinoma.
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