Sharaiha Reem Z, Hajifathalian Kaveh, Kumar Rekha, Saunders Katherine, Mehta Amit, Ang Bryan, Skaf Daniel, Shah Shawn, Herr Andrea, Igel Leon, Dawod Qais, Dawod Enad, Sampath Kartik, Carr-Locke David, Brown Robert, Cohen David, Dannenberg Andrew J, Mahadev Srihari, Shukla Alpana, Aronne Louis J
Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.
Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.
Clin Gastroenterol Hepatol. 2021 May;19(5):1051-1057.e2. doi: 10.1016/j.cgh.2020.09.055. Epub 2020 Oct 1.
The growing burden of obesity as a chronic disease necessitates a multifaceted approach to management. There has been an increase in the number of available endoscopic therapies for weight management with endoscopic sleeve gastroplasty (ESG) proving to be one of the best options. The long-term efficacy of ESG for management of obesity is not known. This study sought to assess the long-term safety and efficacy of ESG for treatment of obesity.
This was a prospective cohort study. Participants underwent ESG in a single academic center, and were prospectively enrolled. All procedures were performed by the same therapeutic endoscopist. Patients with a body mass index of >30 kg/m2 (or >27 with comorbidities), who underwent ESG from August 2013 to August 2019 for treatment of obesity were enrolled. Patients were followed for up to 5 years after their procedure. The primary outcome was weight loss at 5 years after the procedure (% total body weight loss, TBWL) RESULTS: 216 patients (68% female) with a mean age of 46±13 years, and mean BMI of 39±6 kg/m underwent ESG. Out of 216 patients, 203, 96, and 68 patients were eligible for a 1-, 3-, and 5-year follow up, with complete follow-up rates of 70%, 71%, and 82%, respectively. At 5 years, mean TBWL was 15.9% (95% CI, 11.7-20.5, p < .001) and 90 and 61% of patients maintained 5 and 10% TBWL, respectively. There was an overall rate of 1.3% moderate adverse events (AEs), without any severe or fatal AEs.
Our results suggest that ESG is safe and effective for treatment of obesity, with durable long-term results for at least up to 5 years after the procedure. This procedure should be considered as a reliable option for treatment of obesity.
肥胖作为一种慢性病，其负担日益加重，因此需要采取多方面的管理方法。可用于体重管理的内镜治疗方法数量不断增加，其中内镜下袖状胃成形术（ESG）被证明是最佳选择之一。ESG治疗肥胖的长期疗效尚不清楚。本研究旨在评估ESG治疗肥胖的长期安全性和疗效。
这是一项前瞻性队列研究。参与者在单一学术中心接受ESG治疗，并进行前瞻性登记。所有手术均由同一位治疗内镜医师进行。纳入2013年8月至2019年8月因肥胖接受ESG治疗的体重指数>30 kg/m²（或合并症患者体重指数>27）的患者。患者在手术后随访长达5年。主要结局是术后5年的体重减轻（总体重减轻百分比，TBWL）。结果：216例患者（68%为女性）接受了ESG治疗，平均年龄为46±13岁，平均BMI为39±6 kg/m。在216例患者中，203例、96例和68例患者分别符合1年、3年和5年随访条件，完整随访率分别为70%、71%和82%。5年时，平均TBWL为15.9%（95%CI，11.7 - 20.5，p <.001），90%和61%的患者分别维持了5%和10%的TBWL。中度不良事件（AE）的总体发生率为1.3%，无严重或致命AE。
我们的结果表明，ESG治疗肥胖安全有效，术后至少5年有持久的长期效果。该手术应被视为治疗肥胖的可靠选择。
