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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
 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
,
Sérgio Barrichello Jr
 3   Endoscopy Department, Healthme gerenciamento de perda de peso, São Paulo, Brazil
,
Eduardo Guimarães Hourneaux de Moura
 1   Endoscopy Unit, Gastroenterology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
,
Thiago Ferreira de Souza
 4   Endoscopy Department, Faculdade de Medicina do ABC, Santo André, Brazil
,
Manoel dos Passos Galvão Neto
 4   Endoscopy Department, Faculdade de Medicina do ABC, Santo André, Brazil
,
Eduardo Grecco
 4   Endoscopy Department, Faculdade de Medicina do ABC, Santo André, Brazil
,
Bruno Sander
 5   Endoscopy Department, Sander Medical Center, Minas Gerais, Brazil
,
Anna Carolina Hoff
 6   Endoscopy Department, Angioskope Clinic, São Jose dos Campos, Brazil
,
Felipe Matz
 7   Endoscopy Department, Endodiagnostic Clinic, Rio de Janeiro, Brazil
,
Flávio Ramos
 7   Endoscopy Department, Endodiagnostic Clinic, Rio de Janeiro, Brazil
,
João Henrique Felício de Lima
 8   Endoscopy Department, Endobatel Endoscopia Bariátrica Avançada, Paraná, Brazil
,
Leonardo Teixeira
 9   Endoscopy Department, Complexo Hospitalar Niteroi, Rio de Janeiro, Brazil
,
Victor Dib
10   Endoscopy Department, Instituto Victor Dib, Manaus, Brazil
,
Marcelo Falcão
11   Instituto Falcão de endoscopia e cirurgia, Bahia, Brazil
,
Helmut Potti
12   Endoscopy Department, Digestive Center, Fortaleza, Brazil
,
Giorgio Baretta
 8   Endoscopy Department, Endobatel Endoscopia Bariátrica Avançada, Paraná, Brazil
,
Pichamol Jirapinyo
 2   Division of Gastroenterology, Brigham and Women’s Hospital-Harvard Medical School, Boston, Massachusetts, United States
,
Christopher C. Thompson
 2   Division of Gastroenterology, Brigham and Women’s Hospital-Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
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Endoscopic revision of bariatric surgery: expanding the toolboxEndoscopy 2020; 52(03): 166-167
DOI: 10.1055/a-1098-3879

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.

Fig. 1s , Table 1s – 6s



Publication History

Received: 11 June 2019

Accepted: 28 November 2019

Article published online:
15 January 2020

© Georg Thieme Verlag KG
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