Outcomes of Endoscopic Sleeve Gastroplasty in the Elder Population

Abstract

Purpose With the aging of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short- and medium-term outcomes of ESG in patients with obesity aged 65 years and older. Materials and Methods A retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, and the presence of comorbidities were assessed. Results Eighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m2. After ESG, the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12, and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12, and 24 months, respectively. The median BAROS score was 3.0, 3.4, and 2.5 at 6, 12, and 24 months, respectively. Six out of twelve patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. Two out of six patients with OSA stopped therapy with CPAP. No adverse events were recorded. Conclusion According to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suitable for bariatric surgery because of age and comorbidities. Graphical abstract

Success Predictors of Endoscopic Sleeve Gastroplasty

“…However, our analysis suggests that the initial stages witness greater weight loss among the younger population, while a largely similar trend emerges between younger and older patients in the long run. This evidence confirms what was reported in a previous study, supporting the use of ESG as a valid therapeutic strategy also in elder patients with obesity [30].…”

Assessing the predictive value of the suppressed 1 mg overnight dexamethasone suppression test in success of bariatric surgery

“…In the study conducted by Nielsen et al, female gender was shown to result in greater weight loss post-surgery, whereas in the study by Matteo et al, it was demonstrated that gender had no effect on the success of the surgery. [21,22] In our study, we also found that gender did not have any significant impact on postoperative weight loss. The impact of age on postoperative weight loss also yields varying results in studies.…”

A commentary review on endoscopic sleeve gastroplasty: Indications, outcomes and future implications

“…The efficacy of ESG has been examined by multiple non‐randomized studies and a randomized study 5,10,24,29,40 . The recently published MERIT trial proved the superiority of ESG compared with lifestyle modifications alone for weight loss 29 .…”