Endoscopic Sleeve Gastroplasty for the Treatment of Obesity: A Single-Centre Experience and Literature Review

Abstract

Background: In the world, obesity is constantly increasing, and so are the types of medical and surgical therapies. However, to cope with the increase in costs associated with surgical procedures and certain complications, such as gastroesophageal reflux disease, the number of bariatric endoscopic (BE) procedures has been increasing in recent years. Endoscopic sleeve gastroplasty (ESG) is one of the most rapidly increasing BE procedures, given its benefits in terms of patient quality of life and reduced costs. In fact, it is a procedure characterised by minimal postoperative complications and is applicable to different types of bariatric patients. However, the number of studies on BE is not comparable to that on bariatric surgery. Methods: We analyzed the results of 84 ESG performed in our centre and compared them with those presented in the literature. We evaluated 36-Item Short Form Health Survey (SF-36) to 0, six and 13 months, signs and symptoms of patients undergoing ESG on the first and second postoperative day (POD), in terms of abdominal pain, nausea and vomiting. We found a reduction of these outcomes from POD 1 to POD 2. Finally, we measured total body weight loss percentage (TBWL%) and excess weight loss percentage (EWL%) at three, six and 12 months both in patients undergoing bariatric surgery for the first time (specifically, ESG) and in patients previously undergoing bariatric surgery and then undergoing ESG. Results: Using the SF-36 score, we observed an improvement in the physical (mean score from 46.4 at time 0 to 53.6 at 12 months from the ESG) and mental (mean score from 37 at time 0 to 39.9 at 12 months from the ESG) status of the patients. Furthermore, we observed a 0 to 12-month increase in TBWL% and EWL% from the ESG procedure. Furthermore, we observed an increase in TBWL% and EWL% at three, six and 12 months both in patients undergoing bariatric surgery for the first time (specifically ESG) and in patients previously undergoing bariatric surgery and then undergoing ESG. Conclusion: ESG was an effective, reversible, and repeatable surgical procedure for bariatric patients.