Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy

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Abstract

Background Sleeve gastrectomy is a well-standardized surgical treatment for obesity. However, rates of weight regain after sleeve gastrectomy in long-term follow-up are relatively high. This multicenter study is the first to evaluate the use of an endoscopic sleeve gastroplasty (ESG) technique for the management of this population.

Methods This was a multicenter retrospective study, including patients with weight regain following sleeve gastrectomy who underwent ESG for weight loss. Primary outcomes included absolute weight loss, percent total weight loss (%TWL), change in body mass index (BMI), percent excess weight loss (%EWL) at 6 and 12 months, and safety profile. Clinical success was defined as achieving ≥ 25 % EWL at 1 year, ≤ 5 % serious adverse event (SAE) rate following society-recommended thresholds, and %TWL ≥ 10 %.

Results 34 patients underwent ESG after sleeve gastrectomy. Technical success was 100 %. At 1 year, 82.4 % and 100 % of patients achieved ≥ 10 %TWL and ≥ 25 % EWL, respectively. Mean (SD) %TWL was 13.2 % (3.9) and 18.3 % (5.5), and %EWL was 51.9 % (19.1) and 69.9 % (29.9) at 6 months and 1 year, respectively. Mean (SD) %TWL was 14.2 % (12.5), 19.3 % (5.3), 17.5 % (5.2), and 20.4 % (3.3), and %EWL was 88.5 % (52.8), 84.4 % (22.4), 55.4 % (14.8), and 47.8 % (11.2) for BMI categories of overweight and obesity class I, II, and III, respectively, at 1 year. No predictors of success were identified in the multivariable regression analysis. No SAEs were reported.

Conclusion ESG appears to be safe and effective in the management of weight regain following sleeve gastrectomy.

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Author and article information

Journal

Title: Endoscopy

Abbreviated Title: Endoscopy

Publisher: Georg Thieme Verlag KG

ISSN (Print): 0013-726X

ISSN (Electronic): 1438-8812

Publication date Created: February 25 2020

Publication date Created: March 2020

Publication date (Electronic): January 15 2020

Publication date (Print): March 2020

Volume: 52

Issue: 03

Pages: 202-210

Affiliations

[1 ]Endoscopy Unit, Gastroenterology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

[2 ]Division of Gastroenterology, Brigham and Women’s Hospital-Harvard Medical School, Boston, Massachusetts, United States

[3 ]Endoscopy Department, Healthme gerenciamento de perda de peso, São Paulo, Brazil

[4 ]Endoscopy Department, Faculdade de Medicina do ABC, Santo André, Brazil

[5 ]Endoscopy Department, Sander Medical Center, Minas Gerais, Brazil

[6 ]Endoscopy Department, Angioskope Clinic, São Jose dos Campos, Brazil

[7 ]Endoscopy Department, Endodiagnostic Clinic, Rio de Janeiro, Brazil

[8 ]Endoscopy Department, Endobatel Endoscopia Bariátrica Avançada, Paraná, Brazil

[9 ]Endoscopy Department, Complexo Hospitalar Niteroi, Rio de Janeiro, Brazil

[10 ]Endoscopy Department, Instituto Victor Dib, Manaus, Brazil

[11 ]Instituto Falcão de endoscopia e cirurgia, Bahia, Brazil

[12 ]Endoscopy Department, Digestive Center, Fortaleza, Brazil

Article

DOI: 10.1055/a-1086-0627

PubMed ID: 31940667

SO-VID: 6bf7f69b-c275-4ff6-971e-036775019a5e

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