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Gastrointestinal Endoscopy

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Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study - 21/03/19

Doi : 10.1016/j.gie.2018.08.030 
Lea Fayad, MD 1, Atif Adam, MD, MPH, PhD 2, Michael Schweitzer, MD 3, Lawrence J. Cheskin, MD, FACP, FTOS 4, Tokunbo Ajayi, MD 5, Margo Dunlap, BSN 1, Dilhana S. Badurdeen, MD 1, Christine Hill, BA, BS 4, Neethi Paranji, MD 1, Sepehr Lalezari, MD 3, Anthony N. Kalloo, MD 1, Mouen A. Khashab, MD 1, Vivek Kumbhari, MD 1, ⁎
1 Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 
3 Division of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 
5 Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 
2 Johns Hopkins University, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA 
4 Johns Hopkins Weight Management Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA 

∗Reprint requests: Vivek Kumbhari, MD, Director of Endoscopy at JHBMC & Director of Bariatric Endoscopy, Johns Hopkins Medicine, Division of Gastroenterology and Hepatology, 4940 Eastern Avenue, A Building, 5th floor, Baltimore, MD 21224.Director of Endoscopy at JHBMC & Director of Bariatric Endoscopy, Johns Hopkins Medicine, Division of Gastroenterology and Hepatology4940 Eastern Avenue, A Building, 5th floorBaltimoreMD21224

Abstract

Background and Aims

Endoscopic sleeve gastroplasty (ESG) reduces the gastric lumen to a size comparable with that of laparoscopic sleeve gastrectomy (LSG). However, there is a paucity of research comparing outcomes between the 2 procedures. Our study compared the 6-month weight loss outcomes and adverse events of ESG with LSG in a case-matched cohort.

Methods

We retrospectively reviewed prospectively collected data for patients undergoing ESG or LSG at a single academic center. Weight was recorded at 1 and 6 months postprocedure, and percent total body weight loss (%TBWL) was calculated. Adverse events and new-onset Gastroesophageal Reflux Disease (GERD) were also recorded.

Results

A total of 54 ESG patients were matched with 83 LSG patients by age, sex, and body mass index. The proportion of patients with GERD at baseline was similar in the 2 groups (16.7% in ESG group vs 25.3% in LSG group, P = .27). At the 6-month follow-up, %TBWL (compared with baseline) was significantly lower in the ESG group compared with the LSG group (17.1% ± 6.5% vs 23.6% ± 7.6%, P < .01). ESG patients had significantly lower rates of adverse events compared with LSG patients (5.2% vs 16.9%, P < .05). New-onset GERD was also significantly lower in the ESG group compared with the LSG group (1.9% vs 14.5%, P < .05).

Conclusions

ESG, a minimally invasive same-day procedure, achieved less weight loss at 6 months than LSG, with the caveat that LSG caused more adverse events and new-onset GERD than ESG.

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Graphical abstract




Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : BMI, EBT, ESG, LSG, %TBWL


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 DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: A. N. Kalloo: Founding member, equity Holder, and consultant for Apollo Endosurgery. M. A Khashab: Medical advisory board member for Boston Scientific and Olympus America; consultant for Boston Scientific, Olympus America, and Medtronic. V. Kumbhari: Consultant for Medtronic, Reshape Lifesciences, Boston Scientific, and Apollo Endosurgery. All other authors disclosed no financial relationships relevant to this publication.
 See CME section; p. 889.
 If you would like to chat with an author of this article, you may contact Dr Kumbhari at vivekkumbhari@hotmail.com.


© 2019  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 89 - N° 4

P. 782-788 - aprile 2019 Ritorno al numero
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  • The pressure is on! Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: toward better patient allocation beyond pygmalionism
  • Fateh Bazerbachi, Barham K. Abu Dayyeh

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