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

Diogo Turiani Hourneaux de Moura; Sérgio Barrichello Jr; Eduardo Guimarães Hourneaux de Moura; Thiago Ferreira de Souza; Manoel dos Passos Galvão Neto; Eduardo Grecco; Bruno Sander; Anna Carolina Hoff; Felipe Matz; Flávio Ramos; João Henrique Felício de Lima; Leonardo Teixeira; Victor Dib; Marcelo Falcão; Helmut Potti; Giorgio Baretta; Pichamol Jirapinyo; Christopher C. Thompson

doi:10.1055/a-1086-0627

Endoscopy, Inhaltsverzeichnis

Endoscopy 2020; 52(03): 202-210
DOI: 10.1055/a-1086-0627

Original article

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

Diogo Turiani Hourneaux de Moura

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

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

,

Sérgio Barrichello Jr

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

,

Eduardo Guimarães Hourneaux de Moura

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

,

Thiago Ferreira de Souza

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

,

Manoel dos Passos Galvão Neto

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

,

Eduardo Grecco

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

,

Bruno Sander

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

,

Anna Carolina Hoff

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

,

Felipe Matz

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

,

Flávio Ramos

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

,

João Henrique Felício de Lima

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

,

Leonardo Teixeira

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

,

Victor Dib

¹⁰Endoscopy Department, Instituto Victor Dib, Manaus, Brazil

,

Marcelo Falcão

¹¹Instituto Falcão de endoscopia e cirurgia, Bahia, Brazil

,

Helmut Potti

¹²Endoscopy Department, Digestive Center, Fortaleza, Brazil

,

Giorgio Baretta

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

,

Pichamol Jirapinyo

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

,

Christopher C. Thompson

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

› Institutsangaben

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.

Volltext

Referenzen

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