Introduction

Endoscopic sleeve gastroplasty (ESG) is a promising bariatric treatment. Gastric volume reduction and delayed gastric emptying are the probable mechanisms driving weight loss. However, there are concerns regarding the overtime ESG effectiveness. This study aims to evaluate the correlation between endoscopic gastroplasty integrity overtime and weight loss.

Patients and methods

Patients undergoing follow-up endoscopy (6 and 12 months) after ESG were included. ESG were classified in three groups according to endoscopic appearance: open when all the stiches were loose; partially intact if at least one stitch was loose; intact if all the stitches were present and tight. Initial BMI, excess weight loss (%EWL) and total weight loss (%TWL) at 6 and 12 months were assessed against gastroplasty endoscopic appearance.

Results

From October 2016 to April 2019, 133 patients underwent ESG, 87 (65.4%) had a follow-up EGD at 6 months. ESG was open in six cases (6.9%), partially intact in 38 (43.7%) and intact in 43 (49.4%). The overall %EWL and %TWL was 34.5 ± 19.8 and 13.2 ± 7.4, respectively; 25.7 ± 26.9 and 11.8 ± 11.8 for the open group, 30.8 ± 20.1 and 12.4 ± 7.8 for the partially intact group; 39.1 ± 19.7 and 14.0 ± 6.4 for the intact gastroplasty. Forty-one patients underwent a 12 months endoscopy: 10 (24.4%) had an intact ESG, 24 (58.5%) had a partially intact gastroplasty, and in 7 (17.0%) cases the sutures were lost. Overall %EWL and %TWL at 12 months was 34.3 ± 21.9 and 13.1 ± 8.1: 19.3 ± 13.4 and 8.9 ± 6.1 for the open group; 36.0 ± 24.2 and 13.1 ± 8.9 for the partially intact group; 40.3 ± 17.3 and 17.2 ± 5.4 for the intact group. ESG appearance correlated with preoperative BMI (r 0.34; p 0.001) and %EWL at 6 months (r 0.22; p 0.035) and 12 months (r 0.29; p 0.065).

Conclusion

This preliminary work shows that weight loss correlates with ESG endoscopic appearance over time. Initial BMI predicts endoscopic suture duration over time. Larger studies and longer follow-up are needed.

中文翻译：

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内窥镜套管胃成形术经得起时间考验吗？大量连续患者的内镜ESG外观客观评估及其与体重减轻的关系。

介绍

内窥镜套筒胃成形术（ESG）是一种有前途的减肥治疗方法。胃体积减少和胃排空延迟是导致体重减轻的可能机制。但是，对于加班的ESG有效性存在担忧。这项研究的目的是评估内窥镜胃成形术的整体性随着时间的推移与体重减轻之间的相关性。

患者和方法

纳入ESG后接受随访内镜检查（6个月和12个月）的患者。根据内窥镜检查的外观将ESG分为三类：所有切迹均松动时打开；切开后切开。如果至少一根针迹松弛，则部分保留；如果所有针脚都存在且紧绷，则表示完好无损。针对胃成形术的内窥镜外观评估了最初的BMI，6个月和12个月的多余体重减轻（％EWL）和总体重减轻（％TWL）。

结果

从2016年10月到2019年4月，有133例患者接受了ESG，其中87例（65.4％）在6个月时接受了随访。ESG有6例（6.9％）开放，38例（43.7％）部分完好，43例（49.4％）完好。总％EWL和％TWL分别为34.5±19.8和13.2±7.4；开放组为25.7±26.9和11.8±11.8，部分完整组为30.8±20.1和12.4±7.8; 完整的胃成形术为39.1±19.7和14.0±6.4。41例患者接受了12个月的内窥镜检查：10例（24.4％）的ESG完整，24例（58.5％）的胃成形术部分完整，7例（17.0％）缝合线丢失。开放组在12个月时的总％EWL和％TWL为34.3±21.9和13.1±8.1：开放组为19.3±13.4和8.9±6.1；部分完整的组为36.0±24.2和13.1±8.9；完整组为40.3±17.3和17.2±5.4。r 0.34；p 0.001）和％EWL在6个月时（r 0.22; p 0.035）和12个月时（r 0.29; p 0.065）。

结论

这项初步工作表明，随着时间的流逝，体重减轻与ESG内窥镜外观有关。最初的BMI可预测随着时间的推移内窥镜缝合的持续时间。需要更大的研究和更长的随访。