Gontrand Lopez-Nava1, Ravishankar Asokkumar2,3, Anuradha Negi2, Enrique Normand2, Inmaculada Bautista2. 1. Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Calle de Oña, 10, 28050, Madrid, Spain. glopeznava@digestivolopeznava.com. 2. Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Calle de Oña, 10, 28050, Madrid, Spain. 3. Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.
Abstract
INTRODUCTION: Although primary endoscopic sleeve gastroplasty (P-ESG) is effective, some patients may require revision procedures to augment weight loss. We hypothesized that a non-surgical approach using redo ESG (R-ESG) might be a viable option in such patients. We aimed to assess the safety and efficacy of R-ESG following P-ESG to treat obesity. METHODS: We reviewed the outcome of patients who underwent R-ESG at our unit. We classified them as weight loss failure (WF)-< 10% total body weight (TBWL) at 6-months; weight regain (WR)-lost ≥ 10% TBWL and regained 50% of the maximum weight loss at or after 1-year; weight plateau (WP)-lost ≥ 10% TBWL but could not lose further over 3-months. We analyzed the feasibility, safety, and evaluated the efficacy of R-ESG in each group. RESULTS: Of the 482 patients who underwent P-ESG, 35 (7%) required R- ESG (WF-12, WR-12, WP-11). The mean age, weight, BMI (38.2 kg/m2), and the number of sutures used during P-ESG were similar between the groups. The nadir %TBWL was lowest in WF group compared to WR and WP (6.5% vs. 20% vs. 22.4%, p = 0.001). The mean BMI at R-ESG was 33.6 kg/m2. The time to R-ESG was longer in the WR group compared to WF and WP (22.3 vs. 13.4 vs. 13.7 months, p = 0.03). We placed a median of 3 (range 2-6) sutures. R-ESG was technically successful, and no serious complications occurred. All except two patients were discharged on the same day. The overall %TBWL achieved by R-ESG was significantly higher in WP (26%) as compared to WF (11.2%) and WR (12%), respectively (p = 0.001). CONCLUSION: The need for R-ESG after P-ESG is low. R-ESG is safe and induced weight loss in all patients. The maximum benefit was observed in WP.
INTRODUCTION: Although primary endoscopic sleeve gastroplasty (P-ESG) is effective, some patients may require revision procedures to augment weight loss. We hypothesized that a non-surgical approach using redo ESG (R-ESG) might be a viable option in such patients. We aimed to assess the safety and efficacy of R-ESG following P-ESG to treat obesity. METHODS: We reviewed the outcome of patients who underwent R-ESG at our unit. We classified them as weight loss failure (WF)-< 10% total body weight (TBWL) at 6-months; weight regain (WR)-lost ≥ 10% TBWL and regained 50% of the maximum weight loss at or after 1-year; weight plateau (WP)-lost ≥ 10% TBWL but could not lose further over 3-months. We analyzed the feasibility, safety, and evaluated the efficacy of R-ESG in each group. RESULTS: Of the 482 patients who underwent P-ESG, 35 (7%) required R- ESG (WF-12, WR-12, WP-11). The mean age, weight, BMI (38.2 kg/m2), and the number of sutures used during P-ESG were similar between the groups. The nadir %TBWL was lowest in WF group compared to WR and WP (6.5% vs. 20% vs. 22.4%, p = 0.001). The mean BMI at R-ESG was 33.6 kg/m2. The time to R-ESG was longer in the WR group compared to WF and WP (22.3 vs. 13.4 vs. 13.7 months, p = 0.03). We placed a median of 3 (range 2-6) sutures. R-ESG was technically successful, and no serious complications occurred. All except two patients were discharged on the same day. The overall %TBWL achieved by R-ESG was significantly higher in WP (26%) as compared to WF (11.2%) and WR (12%), respectively (p = 0.001). CONCLUSION: The need for R-ESG after P-ESG is low. R-ESG is safe and induced weight loss in all patients. The maximum benefit was observed in WP.
Authors: Abdellah Hedjoudje; Barham K Abu Dayyeh; Lawrence J Cheskin; Atif Adam; Manoel Galvão Neto; Dilhana Badurdeen; Javier Graus Morales; Adrian Sartoretto; Gontrand Lopez Nava; Eric Vargas; Zhixian Sui; Lea Fayad; Jad Farha; Mouen A Khashab; Anthony N Kalloo; Aayed R Alqahtani; Christopher C Thompson; Vivek Kumbhari Journal: Clin Gastroenterol Hepatol Date: 2019-08-20 Impact factor: 11.382
Authors: Manoel Galvao Neto; Rena C Moon; Luiz Gustavo de Quadros; Eduardo Grecco; Admar Concon Filho; Thiago Ferreira de Souza; Luis Augusto Mattar; Jose Americo Gomides de Sousa; Barham K Abu Dayyeh; Helmut Morais; Felipe Matz; Muhammad A Jawad; Andre F Teixeira Journal: Surg Endosc Date: 2019-10-17 Impact factor: 4.584