Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study

Barrichello, Sérgio A.; Moura, Diogo Turiani Hourneaux de; Moura, Eduardo Guimarães Hourneaux de; Jirapinyo, Pichamol; Hoff, Anna Carolina; Fittipaldi-Fernandez, Ricardo J.; Baretta, Giórgio Alfredo Pedroso; Lima, João Henrique Felício de; Usuy, Eduardo N.; Almeida, Leonardo S.; Ramos, Flavio M.; Matz, Felipe; Neto, Manoel dos Passos Galvão; Thompson, Christopher C.

doi:10.1016/j.gie.2019.06.013

Cited by 77 publications

(65 citation statements)

References 42 publications

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“…These first two observations possibly also explain our minimal loss to follow-up rate (2/ 53). Finally, our mean baseline BMI was 35, which was somewhat less than that of most other series 13,15,17,18 and similar to that of Alqahtani et al 19 and Barrichello et al 16 This fact highlights the role of ESG for mild rather than morbid obesity. A recent meta-analysis 20 reported a lower weight loss of 16% and a higher rate (77%) of mild adverse events; however, there were some methodological concerns with the study.…”

Section: Discussionsupporting

confidence: 80%

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Endoscopic sleeve gastroplasty is an effective and safe minimally invasive approach for treatment of obesity: First Indian experience

Bhandari

Jain

Mathur

et al. 2019

Digestive Endoscopy

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Background and Aim: Endoscopic sleeve gastroplasty (ESG) is gaining acceptance as a non-surgical option for the treatment of obesity. However, its role is still not consolidated for all populations and the ideal indications are yet to be determined. We aimed to study the efficacy and safety of ESG in Indian patients. Methods:We conducted a single-center retrospective study of obese patients who underwent consecutive ESG at our tertiary care center. Data on weight loss and adverse events at 1, 3, 6, and 12 months were collected and analyzed. Results: Fifty-three patients underwent ESG from March 2017 toOctober 2018. Eighty one percent of patients were female (43/53). Mean baseline age and body mass index were 40.54 AE 13.79 years and 34.78AE 5.20 kg/m 2 , respectively. Mean duration of procedure was 68.96 AE 11.19 min. Immediate postoperative complications included mainly epigastric pain (45.2%) and nausea (22.6%) but there was no serious adverse event. Average percentage of total weight loss (%TWL) was 8.26%, 11.96%, 14.25%, and 19.94% at 1, 3, 6, and 12 months, respectively. Eighty-eight percent of patients achieved >15% TWL at 12 months. Younger patients (<30 years old) and female patients had greater %TWL at 12 months (P = 0.01 and P = 0.021, respectively). Last 18 procedures were significantly faster than the first 35 cases (P = 0.01).Conclusions: Endoscopic sleeve gastroplasty is effective and safe at promoting weight loss in the Indian population. Young age and female gender are related to better outcomes.

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Section: Discussionsupporting

confidence: 80%

“…14 Also, mean TWL% was similar to the results from other ESG series, but usually patients achieve this level of %TWL at 2 years. 13,15,16 Our cohort was able to lose weight more rapidly than that of most previous studies. Three factors may have elicited such faster weight loss.…”

Section: Discussionmentioning

confidence: 71%

Endoscopic sleeve gastroplasty is an effective and safe minimally invasive approach for treatment of obesity: First Indian experience

Bhandari

Jain

Mathur

et al. 2019

Digestive Endoscopy

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“…The study by Kumar et al [32] was not included as it was the first in man trial focused on procedure development and reproducibility of ESG technique. Fifteen studies were included in the final analysis, of which 8 studies reported on the outcomes with ESG [33][34][35][36][37][38][39][40] and seven reported on the outcomes with LSG [41][42][43][44][45][46][47]. The schematic diagram of study selection is illustrated in Supplementary Fig.…”

Section: Search Results and Population Characteristicsmentioning

confidence: 99%

“…Four of the seven ESG studies were prospective [34][35][36]39] whereas one that was a randomized controlled trial and all other LSG studies were retrospective [47]. Two ESG studies were from multi-center data [37,40] and the rest were single center. None were population-based.…”

Section: Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

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Outcomes of endoscopic sleeve gastroplasty; how does it compare to laparoscopic sleeve gastrectomy? A systematic review and meta-analysis

et al. 2020

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Background and study aims Endoscopic sleeve gastroplasty (ESG) is a novel moderately invasive technique in endo-bariatrics as compared to laparoscopic sleeve gastrectomy (LSG). Data is limited as to its efficacy and safety. Methods We searched multiple databases from inception through August 2019 to identify studies that reported on ESG in the treatment of obesity. Our goals were to calculate the pooled rates of total weight loss (%TWL), excess weight loss (%EWL), and body mass index (BMI) at 1 month, 6 months, and 12 months with ESG. We included studies that reported on LSG, in a similar time frame as ESG, and compared the 12-month outcomes. Results From eight studies on ESG (1815 patients), the pooled rates of %TWL at 1 month, 6 months, and 12 months were 8.7 (7.2–10.2), 15.3 (14.1–16.6) and 17.1 (15.1–19.1), respectively. The pooled rates of %EWL at 1 month, 6 months, and 12 months were 31.7 (29.3–34.1), 59.4 (57–61.8) and 63 (51.3–74.6), respectively. The pooled rates of BMI at 1 m, 6 m, and 12 m were 32.6 (31–34.3), 30.4 (29–31.8) and 30 (27.7–32.3, I2 = 97), respectively. At 12 months, the pooled %TWL, %EWL and BMI with LSG (7 studies, 2179 patients) were 30.5 (27.4–33.5), 69.3 (60.1–78.4) and 29.3 (27.1–31.4) respectively. On comparison analysis, %TWL with LSG was superior to ESG (P = 0.001). %EWL and BMI were comparable. All adverse events, bleeding and gastro-esophageal reflux disease were significantly lower with ESG when compared to LSG. Conclusion ESG demonstrates acceptable weight loss parameters and seems to have a better safety profile when compared to LSG.

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Safety and early efficacy of endoscopic sleeve gastroplasty (ESG) for obesity in a multi‐ethnic Asian population in Singapore

et al. 2021

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Background and Aim: Endoscopic sleeve gastroplasty (ESG) is an alternative nonsurgical treatment option for obesity. However, most studies on the utility and efficacy of ESG are derived from the Western population. It is unknown if ESG elicits similar results in Asians with different fat distribution, sociocultural customs, and dietary practices. Our study aims to assess the safety and efficacy of ESG among a multiethnic Asian population. Methods: We reviewed 35 patient records who underwent primary ESG for obesity at our unit. We followed a U-shaped suture pattern. Our primary outcome was to assess technical feasibility and safety. The secondary outcome was to determine the percentage total body weight loss (TBWL) at the last follow-up. Results: The mean AE SD age and body mass index were 43.6 AE 11.3 years and 34 AE 4.9 kg/m 2 , respectively. The majority were female (57%) and of Chinese ethnicity (51%). The procedure was technically successful in all patients. We used an average of five sutures (range, 4-7), and the mean AE SD procedure time was 65 AE 10 min. No major complications occurred, and the average length of stay was 1 day. Twenty-one patients completed 3 months of follow-up, and 10 patients 6 months. The mean AE SD TBWL at 3 and 6 months were 14.5 AE 4.8% and 16.2 AE 4.9%, respectively. We observed improvement in diabetes mellitus (87%), fatty liver (86%), and hypertension (58%) during the follow-up. Conclusion: ESG is a safe and effective option for promoting weight loss in a multiethnic Asian population. ESG-induced weight loss may improve obesity-related comorbidities.

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Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study

Cited by 77 publications

References 42 publications

Endoscopic sleeve gastroplasty is an effective and safe minimally invasive approach for treatment of obesity: First Indian experience

Endoscopic sleeve gastroplasty is an effective and safe minimally invasive approach for treatment of obesity: First Indian experience

Outcomes of endoscopic sleeve gastroplasty; how does it compare to laparoscopic sleeve gastrectomy? A systematic review and meta-analysis

Safety and early efficacy of endoscopic sleeve gastroplasty (ESG) for obesity in a multi‐ethnic Asian population in Singapore

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