Institute of image-guided surgery (IHU),1 place de l'Hôpital, 67091, Strasbourg, France.
Digestive Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 8 Largo A. Gemelli, 00166, Rome, Italy.
Obes Surg. 2020 May;30(5):1944-1951. doi: 10.1007/s11695-020-04419-1.
Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed bariatric procedure. Endoscopic sleeve gastroplasty (ESG) is a promising new bariatric technique which is less invasive in its approach. To date no study has compared quality of life (QoL) outcomes between LSG and ESG. The aim of this study is to compare QoL after ESG and LSG using a propensity score analysis.
QoL was evaluated by means of Gastrointestinal Quality of Life Index (GIQLI) questionnaire before and 6 months after the procedure. Patients were matched for age, sex, preoperative weight, and comorbidities.
Propensity score matching resulted in 23 pairs of patients homogeneous for age (p = 0.3), preoperative BMI (p = 0.3), sex (p = 0.74), and comorbidities (p = 0.9). Post-ESG patients, despite a less important %EWL (39.9 (17.5-58.9)vs 54.9 (46.2-65); p = 0.01) and %TWL (13.4 (7.8-20.9) vs 18.8 (17.6-21.8); p = 0.03), presented better QoL (14 [3-24] vs 13 (- 1-23) ΔGIQLI score; p = 0.79) with clear advantage for the gastrointestinal symptoms subdomain (66.5 (61-70.5) vs 59 (55-63); p = 0.001), while post-LSG patients presented a worsening of GERD symptoms (30.7% vs 0%) and an increased use of PPI therapy (p = 0.004). Resolution or improvement of comorbidities was similar (ESG 53% vs LSG 45.8%; p = 0.79) in both groups.
LSG may significantly affect QoL and results in worsening of gastrointestinal symptoms including GERD. ESG is a promising less invasive bariatric endoscopic procedure that demonstrated a positive impact on both QoL and comorbidities, which could lead to greater patient acceptance earlier in their disease or at a younger age.
腹腔镜袖状胃切除术（LSG）是目前最常施行的减重手术。内镜下袖状胃成形术（ESG）是一种有前途的新减重技术，其手术方式的侵入性更小。迄今为止，尚无研究比较 LSG 和 ESG 之间的生活质量（QoL）结局。本研究旨在通过倾向评分分析比较 ESG 和 LSG 后的 QoL。
使用胃肠道生活质量指数（GIQLI）问卷在术前和术后 6 个月评估 QoL。患者根据年龄、性别、术前体重和合并症进行匹配。
倾向评分匹配后，年龄（p = 0.3）、术前 BMI（p = 0.3）、性别（p = 0.74）和合并症（p = 0.9）均相似的 23 对患者。ESG 术后患者尽管减重效果不那么显著（%EWL：39.9（17.5-58.9）比 54.9（46.2-65）；p = 0.01）和 %TWL：13.4（7.8-20.9）比 18.8（17.6-21.8）；p = 0.03），但 QoL 更好（14 [3-24]比 13（-1-23）ΔGIQLI 评分；p = 0.79），胃肠道症状亚量表的优势更为明显（66.5（61-70.5）比 59（55-63）；p = 0.001），而 LSG 术后患者 GERD 症状恶化（30.7%比 0%）和 PPI 治疗使用率增加（p = 0.004）。两组患者的合并症缓解或改善情况相似（ESG：53%比 LSG：45.8%；p = 0.79）。
LSG 可能会显著影响 QoL，并导致胃肠道症状恶化，包括 GERD。ESG 是一种有前途的微创减重内镜手术，对 QoL 和合并症均有积极影响，这可能会使患者更早或更年轻时接受治疗。
