Margherita Pizzicannella1, Claudio Fiorillo2, Manuel Barberio3, María Rita Rodríguez-Luna4, Michel Vix5, Didier Mutter5, Jacques Marescaux4, Guido Costamagna6, Lee Swanström3, Silvana Perretta7. 1. IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France. Electronic address: marghe.pizzicannella@gmail.com. 2. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 3. IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France. 4. IRCAD, Research Institute against Digestive Cancer, Strasbourg, France. 5. Department of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France. 6. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; CERTT Centre for Endoscopic Research Therapeutics and Training, Università Cattolica S. Cuore, Rome, Italy. 7. IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France; IRCAD, Research Institute against Digestive Cancer, Strasbourg, France; Department of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.
Abstract
BACKGROUND: Endoscopic sleeve gastroplasty (ESG) is a promising bariatric endoluminal procedure. Restriction and shortening of the stomach are obtained by means of non-resorbable full-thickness sutures, thus inducing the formation of several endoluminal pouches in which food can stagnate. The effect of ESG on the upper gastrointestinal tract has never been investigated. OBJECTIVES: This study objectively evaluates endoscopic macroscopic and histopathologic changes within 12-month follow-up (FU) in patients who underwent ESG. SETTING: Retrospective study on a prospective database of patients who underwent ESG at our tertiary referral center between October 2016 and March 2019. METHODS: All consecutive patients undergoing upper endoscopy (EGD) preoperatively and 6 and 12 months after ESG were included. The upper gastrointestinal tract was evaluated for mucosal abnormalities and biopsies were systematically taken. RESULTS: Eighty-six patients were included. EGD results were as follows: esophagitis decreased from 14% preoperatively to 3.6% and 1.2% at 6- and 12-month FU, respectively (P = .001); 19.8% of patients presented preoperatively a type I hiatal hernia <4 cm and showed no size increment or de novo hiatal hernia at 6- and 12-months. The rate of preoperative hyperemic (23.2%) and erosive (3.5%) gastropathy decreased to 9.5% and 1.2% at 6 months and 17.4% and 1.2% at 12 months, respectively. Gastric ulcer (4.7%), duodenal hyperemic mucosa (1.2%) and duodenal micro-ulcerations (2.3%) detected preoperatively were not present at 6- and 12-month EGD. The rate of histopathological disease, which was 68.1% preoperatively, dropped to 29.2% at 12 months, chronic gastritis decreased from 40.3% to 26.4%, acute gastritis from 9.7% to 0%, and acute inflammation on chronic gastritis from 18% to 2.8% (P < .001). CONCLUSION: ESG is a safe procedure that does not promote the new onset of macroscopic and histopathologic abnormalities within 1-year follow-up.
BACKGROUND: Endoscopic sleeve gastroplasty (ESG) is a promising bariatric endoluminal procedure. Restriction and shortening of the stomach are obtained by means of non-resorbable full-thickness sutures, thus inducing the formation of several endoluminal pouches in which food can stagnate. The effect of ESG on the upper gastrointestinal tract has never been investigated. OBJECTIVES: This study objectively evaluates endoscopic macroscopic and histopathologic changes within 12-month follow-up (FU) in patients who underwent ESG. SETTING: Retrospective study on a prospective database of patients who underwent ESG at our tertiary referral center between October 2016 and March 2019. METHODS: All consecutive patients undergoing upper endoscopy (EGD) preoperatively and 6 and 12 months after ESG were included. The upper gastrointestinal tract was evaluated for mucosal abnormalities and biopsies were systematically taken. RESULTS: Eighty-six patients were included. EGD results were as follows: esophagitis decreased from 14% preoperatively to 3.6% and 1.2% at 6- and 12-month FU, respectively (P = .001); 19.8% of patients presented preoperatively a type I hiatal hernia <4 cm and showed no size increment or de novo hiatal hernia at 6- and 12-months. The rate of preoperative hyperemic (23.2%) and erosive (3.5%) gastropathy decreased to 9.5% and 1.2% at 6 months and 17.4% and 1.2% at 12 months, respectively. Gastric ulcer (4.7%), duodenal hyperemic mucosa (1.2%) and duodenal micro-ulcerations (2.3%) detected preoperatively were not present at 6- and 12-month EGD. The rate of histopathological disease, which was 68.1% preoperatively, dropped to 29.2% at 12 months, chronic gastritis decreased from 40.3% to 26.4%, acute gastritis from 9.7% to 0%, and acute inflammation on chronic gastritis from 18% to 2.8% (P < .001). CONCLUSION:ESG is a safe procedure that does not promote the new onset of macroscopic and histopathologic abnormalities within 1-year follow-up.
Authors: Maria V Matteo; Vincenzo Bove; Valerio Pontecorvi; Martina De Siena; Gabriele Ciasca; Massimiliano Papi; Giulia Giannetti; Giorgio Carlino; Marco Raffaelli; Guido Costamagna; Ivo Boškoski Journal: Obes Surg Date: 2022-08-02 Impact factor: 3.479