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From Early to Mid-Term Results of Endoscopic Sleeve Gastroplasty: A Retrospective Analysis of a Bariatric Center

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Abstract

Purpose

Global obesity rates have surged, necessitating effective interventions beyond traditional bariatric and metabolic surgery (BMS). Endoscopic Sleeve Gastroplasty (ESG) has emerged as a minimally invasive alternative, addressing limitations of eligibility criteria and patient reluctance associated with BMS. This study aims to present a 3-year experience with ESG, focusing on its mid-term efficacy in weight loss.

Materials and Methods

A retrospective, single-center study included 143 consecutive ESG patients (BMI > 30 kg/m2 or > 25 kg/m2 with obesity associated-diseases) from February 2019 to March 2023. Data on demographics, comorbidities, operative details, and follow-up outcomes were collected. The primary outcome was %TWL ≥ 15% at 12 months. Secondary outcomes were an optimal clinical response (OCR) at 24 and 36 months defined by %TWL ≥ 10% or %EWL ≥ 25%.

Results

ESG demonstrated a mean %TWL of 14.37% at 12 months, aligning with previous studies. Early postoperative complications were minimal (2.1%), with no mortality. Follow-up revealed a peak in weight loss at 9 months, but mid-term OCR was achieved in 41.2% at 3 years. The learning curve showed efficiency improvements after 26 procedures.

Conclusion

ESG proves effective at one year, with a %TWL of 14.37%. However, mid-term efficacy beyond 12 months remains challenging, raising questions about the durability of weight loss. Despite a low complication rate, strategies for maintaining a long-term OCR, including potential repeat ESG, warrant further investigation.

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Funding

The authors have no funding to declare. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Digestive Surgery, Hospital Archet, University Hospital of Nice, Nice, France

    Sébastien Frey, Eric Sejor & Dorith Benamran

  2. University of Côte d’Azur, Nice, France

    Sébastien Frey & Dorith Benamran

  3. Department of Bariatric Surgery, Private Hospital of Provence, 235 All. Nicolas de Staël, 13080, Aix-en-Provence, France

    Pierre-Alain Cougard & Hugues Sebbag

Authors
  1. Sébastien Frey
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  2. Eric Sejor
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  3. Pierre-Alain Cougard
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  4. Dorith Benamran
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  5. Hugues Sebbag
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Contributions

Sebastien Frey: performed the literature search, participated in the design of the study, data collection and interpretation. Wrote and submitted the manuscript. Eric Sejor: participated in the design of the study and and revised the manuscript critically. Pierre-Alain Cougard: revised the manuscript critically. Dorith Benamran: participated the data collection and wrote parts of the manuscript. Hugues Sebbag: performed the literature search, participated in the design of the study and the data collection, and revised the manuscript critically. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Hugues Sebbag.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Key Points

• ESG demonstrates effectiveness in achieving a mean %TWL of 14.37% at 12 months.

• Despite an early optimal clinical response the study highlights challenges in sustaining weight loss beyond 12 months with ESG.

• Mid-term optimal clinical response (%TWL ≥ 10% or %EWL ≥ 25%) is achieved in only 41.2% of patients at 3 years.

• This study also outlines a learning curve for ESG, revealing efficiency improvements after 26 procedures.

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Frey, S., Sejor, E., Cougard, PA. et al. From Early to Mid-Term Results of Endoscopic Sleeve Gastroplasty: A Retrospective Analysis of a Bariatric Center. OBES SURG (2024). https://doi.org/10.1007/s11695-024-07313-2

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