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

Abstract

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.

Laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty: a systematic review and meta-analysis

“…Two studies were excluded due to too small sample size 25 26 . Many that met our inclusion criteria did not provide data on 12 months follow up EWL%, so their authors were contacted to get more detailed information; for some of them, we were kindly given a comprehensive answer 27 28 29 30 …”

“…One randomized study 31 and seven observational studies 27 32 33 34 35 36 37 on LSG were eventually selected. Likewise, a total of eight observational studies 28 29 30 38 39 40 41 42 on ESG were included in the analysis ( Fig. 1 , Table 1 ).…”

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

“…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.…”

“…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.…”

“…Detailed assessment of study quality can be found in Supplementary Table 1. Overall, three studies [37,39,40] were considered high quality and the rest were medium quality. There were no low-quality studies.…”