Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study

Aug 28, 2018Gastrointestinal endoscopy

Comparing endoscopic and surgical sleeve procedures for weight loss in matched patients

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Abstract

At 6 months, 17.1% total body weight loss was recorded for patients undergoing endoscopic sleeve gastroplasty (ESG), compared to 23.6% for those undergoing laparoscopic sleeve gastrectomy (LSG).

Patients undergoing ESG experienced a significantly lower percent total body weight loss compared to those undergoing LSG.
The rate of adverse events was significantly lower in the ESG group than in the LSG group.
New-onset Gastroesophageal Reflux Disease (GERD) occurred less frequently in the ESG group compared to the LSG group.
The baseline proportion of patients with GERD was similar between the ESG and LSG groups.

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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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Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study

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