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Endoscopy 2019; 51(06): 532-539
DOI: 10.1055/a-0852-3441
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic sleeve gastroplasty versus intragastric balloon insertion: efficacy, durability, and safety

Lea Fayad
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Lawrence J. Cheskin
2   Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
,
Atif Adam
2   Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
,
Dilhana S. Badurdeen
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Christine Hill
2   Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
,
Abhishek Agnihotri
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Margo Dunlap
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Cem Simsek
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Mouen A. Khashab
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Anthony N. Kalloo
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
,
Vivek Kumbhari
1   Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
› Author Affiliations
Further Information

Publication History

submitted 27 May 2018

accepted after revision 14 January 2019

Publication Date:
06 March 2019 (online)

Also available at
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To balloon or to suture, that is the questionEndoscopy 2019; 51(06): 513-514
DOI: 10.1055/a-0894-4479

Abstract

Background Intragastric balloon (IGB) placement and endoscopic sleeve gastroplasty (ESG) are reported to be safe and effective endoscopic bariatric therapies. This study aimed to compare the patient demographics and therapeutic outcomes between the IGB and ESG procedures.

Methods: This was a retrospective review of prospectively collected data from consecutive patients between December 2015 and October 2017 who underwent IGB or ESG at a single academic center. Fluid-filled IGBs implanted for a 6-month duration were used. IGB and ESG patients were subjected to identical post-procedure dietary instructions and follow-up protocols. Body weight was recorded at 1, 3, 6, and 12 months post-procedure.

Results A total of 47 patients underwent IGB insertion and 58 underwent ESG. The IGB cohort had a lower baseline body mass index (BMI) than the ESG (34.5 vs. 41.5 kg/m2; P < 0.001) and a significantly lower proportion of men (2.1 % vs. 41.4 %; P < 0.001). IGB patients showed a mean (standard deviation [SD]) percentage total body weight loss (%TBWL) that was significantly lower than ESG patients at 1 month (6.6 % [2.6 %] vs. 9.9 % [2.4 %]; P < 0.001), 3 months (11.1 % [4.4 %] vs. 14.3 % [4.6 %]; P = 0.004), 6 months (15.0 % [7.6 %] vs. 19.5 % [5.7 %]; P = 0.01), and 12 months (13.9 % [9.0 %] vs. 21.3 % [6.6 %]; P = 0.005). The IGB cohort also experienced significantly more adverse events compared with the ESG (17 % vs. 5.2 %; P = 0.048).

Conclusions IGB placement and ESG result in clinically meaningful weight loss. However, ESG appears to provide clinically superior and more enduring weight loss with fewer adverse events compared with an IGB.

 

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