Espinet-Coll E, Nebreda-Durán J, Galvao-Neto M, Bautista-Altamirano C, Diaz-Galán P, Gómez-Valero J A, Vila-Lolo C, Guirola-Puche M A, Fernández-Huélamo A, Bargalló-Carulla D, Juan-Creix Comamala A
Bariatric Endoscopy Unit. Dexeus University Hospital, Barcelona, Spain.
Bariatric Endoscopy Unit. Endosmedicina, Diagonal Clinic, Barcelona, Spain.
Endosc Int Open. 2020 Oct;8(10):E1349-E1358. doi: 10.1055/a-1221-9835. Epub 2020 Sep 22.
ESG is an effective and safe medium-term procedure for obesity treatment. A variety of suture patterns have been reported. We aimed to compare whether there are differences in efficacy depending on suture pattern used. Retrospective and comparative review of 5 years of prospectively collected data, including consecutive obese patients undergoing ESG at two collaborative centers. Primary outcomes included weight loss (mainly % total body weight loss [TBWL] and % exces weight loss [EWL]) at 12 months and safety profile. We compared them according to three suture patterns (transverse bilinear [TBp], longitudinal [Lp] and transverse monolinear [TMp]), and number of sutures (4 - 7) and stitches (< 25, 25 to 30 and > 30) applied. Evolution of major obesity-associated morbidities (hypertension, dyslipidemia, Type 2 diabetes mellitus (T2DM), sleep obstructive apnea syndrome, and arthropathy) were also described. 88 patients (mean age 46.1±12.3 years, 69.3 % female) underwent ESG. Mean body mass index (BMI) at baseline was 39.40 ± 4.69 kg/m². At 1 year, %TBWL was 17.36 ± 6.09 % (%EWL 46.41±20.6 %) with TBWL > 10 % in 95.5 % of patients (EWL > 25 % in 94.3 % of patients). According to pattern, there were no differences in %TBWL but there were in %EWL (43.7 ± 20.4 %, 59.8 ± 18.9 % and 45.4 ± 14.9 % in TBp, Lp and TMp patterns, respectively) ( = 0.034). No differences were found related to number of sutures (mean 5.2 ± 0.73, r = 4 - 7) or stitches (mean 27.4 ± 6.50, r = 18 - 50) applied. Forty-three of 72 (59.7 %) major comorbidities were resolved. No serious adverse events were observed with any pattern. ESG is an effective procedure at 12-month follow-up for weight loss and comorbidity resolution. All three analyzed patterns are safe and effective without differences in %TBWL, but there was a slight increase in %EWL in Lp, regardless of the number of sutures or stitches applied.
内镜下胃折叠术（ESG）是一种治疗肥胖症的有效且安全的中期手术。已有多种缝合方式被报道。我们旨在比较不同缝合方式在疗效上是否存在差异。对两个合作中心连续接受ESG的肥胖患者进行了为期5年的前瞻性收集数据的回顾性和对比性分析。主要结局指标包括12个月时的体重减轻情况（主要是总体重减轻百分比[TBWL]和超重减轻百分比[EWL]）以及安全性。我们根据三种缝合方式（横向双线缝合[TBp]、纵向缝合[Lp]和横向单线缝合[TMp]）以及应用的缝合针数（4 - 7针）和缝线数（<25针、25至30针和>30针）进行比较。还描述了主要肥胖相关疾病（高血压、血脂异常、2型糖尿病[T2DM]、睡眠呼吸暂停综合征和关节病）的演变情况。88例患者（平均年龄46.1±12.3岁，69.3%为女性）接受了ESG手术。基线时平均体重指数（BMI）为39.40±4.69kg/m²。1年后，TBWL百分比为17.36±6.09%（EWL百分比为46.41±20.6%），95.5%的患者TBWL>10%（94.3%的患者EWL>25%）。根据缝合方式，TBWL百分比无差异，但EWL百分比有差异（TBp、Lp和TMp方式下分别为43.7±20.4%、59.8±18.9%和45.4±14.9%）（P = 0.034）。在应用的缝合针数（平均5.2±0.73针，范围4 - 7针）或缝线数（平均27.4±6.50针，范围18 - 50针）方面未发现差异。72例主要合并症中有43例（59.7%）得到缓解。未观察到任何一种缝合方式有严重不良事件。ESG在12个月随访时是一种有效的减肥和缓解合并症的手术。所有三种分析的缝合方式都是安全有效的，TBWL百分比无差异，但无论应用的缝合针数或缝线数如何，Lp方式下EWL百分比略有增加。
