Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients.

BACKGROUND

Bariatric surgery for severe obesity has demonstrated significant health benefits, but it is not without complications. Transoral approaches to weight loss offer a minimally invasive option.

OBJECTIVE

To evaluate the safety and feasibility of a transoral suturing procedure for weight loss.

DESIGN

Single-center, uncontrolled study with a 1-year follow-up.

SETTING

Hospital de Clinicas, Caracas, Venezuela.

PATIENTS

Sixty-four patients (mean age [SD] 31.5 +/- 10.1 years, range 16-62 years; mean (SD) preoperative body mass index [BMI] 39.9 +/- 5.1 kg/m(2), range 28.0-60.2 kg/m(2)) were enrolled between 2003 and 2005.

INTERVENTION

Endoluminal vertical gastroplasty by using a continuous suture pattern to treat obesity.

MAIN OUTCOME MEASUREMENTS

Short-term complication monitoring and patient weight before the procedure and at 1, 3, and 12 months after the procedure.

RESULTS

The outpatient procedures were performed in approximately 45 minutes. Patients had a significant reduction in BMI at 12 months (mean [SD] BMI 39.9 +/- 5.1 kg/m(2) vs 30.6 +/- 4.7 kg/m(2); P < .001) and a percentage of excess weight loss (%EWL) (SD) of 21.1 +/- 6.2, 39.6 +/- 11.3, and 58.1 +/- 19.9 at 1, 3, and 12 months, respectively. By comparing the study's subpopulations, group I (baseline BMI >or=40 kg/m(2), n = 33), group II (baseline BMI 35-40 kg/m(2), n = 19), and group III (baseline BMI <35 kg/m(2), n = 12) demonstrated a %EWL (SD) of 48.9 +/- 10.7, 56.5 +/- 13.9, and 85.1 +/- 24.0, respectively, at 12 months after the procedure (P = .037 when comparing group I vs II; P < .001 when comparing group II vs III and group I vs III). No patients experienced any serious adverse events.

LIMITATIONS

This study represents a single center's clinical experience, with no sham control.

CONCLUSIONS

Endoluminal vertical gastroplasty by using a continuous suture pattern is associated with significant weight loss. Additional studies are needed to demonstrate the procedure's long-term safety and efficacy.