Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success

G Lopez-Nava, M Galvao, I Bautista-Castaño, J P Fernandez-Corbelle, M Trell, G Lopez-Nava, M Galvao, I Bautista-Castaño, J P Fernandez-Corbelle, M Trell

Abstract

Background and study aims: Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity. The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure.

Patients and methods: Prospective single-center follow-up study of 25 patients (5 men, 20 women) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided post-procedure care. Patient outcomes were recorded at 1 year after the procedure. Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up.

Results: Mean body mass index (BMI) was 38.5 ± 4.6 kg/m(2) (range 30 - 47) and mean age 44.5 ± 8.2 years (range 29 - 60). At 1 year, 22 patients continued with the follow-up (2 dropped out at 6 months and 1 at 3 months). There were no major intra-procedural, early, or delayed adverse events. Mean BMI loss was 7.3 ± 4.2 kg/m(2), and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year. In the linear regression analysis, adjusted by initial BMI, variables associated with %TBWL involved the frequency of nutritional (β = 0.563, P = 0.014) and psychological contacts (β = 0.727, P = 0.025). The number of nutritional and psychological contacts were predictive of good weight loss results.

Conclusions: Endoscopic sleeve gastroplasty is a feasible, reproducible, and effective procedure to treat obesity. Nutritional and psychological interaction are predictive of success.

Conflict of interest statement

Competing intersts: Dr. Lopez-Nava and Dr. Galvao are consultants for Apollo Endosurgery in the United States.

Figures

Fig. 1
Fig. 1
Relationship between nutritional follow-up controls per year and weight loss parameters.
Fig. 2
Fig. 2
Relationship between psychological follow-up controls per year and weight loss parameters.
Fig. 3
Fig. 3
Change in eating, sleep and sedentary habits: initial and 1-year prevalence.
Fig. 4
Fig. 4
Contrast Rx image of the endoscopic sleeve gastroplasty with the greater curvature modified by a line of sutured plications (the arrows indicate the location of the plications) at 1 year post-procedure
Fig. 5
Fig. 5
Luminal endoscopic view of the gastric body reduced into a tubular configuration at 1 year post- procedure

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