Espinet-Coll Eduard, Díaz-Galán Patricia, Nebreda-Durán Javier, Gómez-Valero José A, Vila-Lolo Carmen, Bautista-Altamirano Carmen, Bargalló-García Ana, Galvao-Neto Manoel, Muñoz-Navas Miguel, Bargalló-Carulla Domingo
Bariatric Endoscopy Unit, Dexeus University Hospital and Diagonal Clinic, Sabino de Arana, 5-15, 08028, Barcelona, Spain.
Bariatric Endoscopy Unit, Clínica Avendaño, Lima, Perú.
Obes Surg. 2022 Jun;32(6):1969-1979. doi: 10.1007/s11695-022-06039-3. Epub 2022 Mar 30.
Endoscopic sleeve gastroplasty (ESG) is an effective medium-term procedure for obesity treatment. There are no consistent studies confirming persistence of maintained gastric tubular configuration. We determined sleeve duration, gastric reduction degree, and suture persistence at 12-month follow-up.
This is a prospective, single-center study, including patients with obesity undergoing ESG with at least 1-year follow-up, who underwent the following: (1) Barium X-ray study (BS) prior and at 6 months, assessing degree of gastric reduction (severe, moderate, or mild), and (2) gastroscopy at 12 months, accounting the number of persistent sutures (tense, lax, or absent). Secondary outcomes were weight loss data and procedure safety profile.
Thirty-eight patients (30 women), median age of 47.0 [40.0-51.0] years, and average baseline BMI of 37.6 [35.5-41.5] kg/m were included. Median %TWL of 17.1% [16.1-22.3%] with TWL > 10% in 94.7% of patients was obtained at 1 year. No major AEs were observed. Six months BS was performed on 30 patients: 12 (40.0%), 14 (46.7%), and 4 (13.3%) patients showed severe, moderate, and mild gastric reduction, respectively. Twelve months gastroscopy was performed on 22 patients with 83.64% of sutures persisting (92 of 110, mean 4.2 of 5.0 sutures/patient) and 70.9% with adequate tension. We found intact sutures in 12 patients (54.5%), and 10 patients (45.5%) had some suture detached (average 1.8, r = 1-3). There were no differences in %TWL according to BS reduction (p = 0.662) or number of persistent sutures (p = 0.678).
ESG is an effective and safe weight loss strategy at 12-month follow-up with persistence of most sutures and maintenance of notable gastric reduction and remodeling.
内镜下袖状胃成形术（ESG）是一种治疗肥胖症的有效中期手术。目前尚无一致的研究证实维持胃管状结构的持久性。我们在12个月的随访中确定了袖状胃的持续时间、胃缩小程度和缝线的持久性。
这是一项前瞻性单中心研究，纳入了接受ESG且至少随访1年的肥胖患者，这些患者接受了以下检查：（1）术前及6个月时进行钡餐X线检查（BS），评估胃缩小程度（重度、中度或轻度）；（2）12个月时进行胃镜检查，统计持续存在的缝线数量（拉紧、松弛或缺失）。次要结局为体重减轻数据和手术安全性。
共纳入38例患者（30例女性），中位年龄47.0[40.0 - 51.0]岁，平均基线体重指数为37.6[35.5 - 41.5]kg/m²。1年时获得的中位%TWL为17.1%[16.1 - 22.3%]，94.7%的患者TWL>10%。未观察到重大不良事件。30例患者进行了6个月的钡餐X线检查：分别有12例（40.0%）、14例（46.7%）和4例（13.3%）患者显示重度、中度和轻度胃缩小。22例患者进行了12个月的胃镜检查，83.64%的缝线持续存在（110条中的92条，平均每位患者5.0条缝线中有4.2条），70.9%的缝线张力合适。我们发现12例患者（54.5%）的缝线完整，10例患者（45.5%）有部分缝线脱落（平均1.8条，范围为1 - 3条）。根据钡餐X线检查的胃缩小程度（p = 0.662）或持续存在的缝线数量（p = 0.678），%TWL无差异。
在12个月的随访中，ESG是一种有效且安全的减肥策略，大多数缝线持续存在，胃缩小和重塑得以维持。
