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True You Weight Loss, Cary, NC.
Surg Laparosc Endosc Percutan Tech. 2024 Apr 1;34(2):185-189. doi: 10.1097/SLE.0000000000001265.
The performance of endoscopic sleeve gastroplasty (ESG) in patients with prior laparoscopic adjustable gastric band (LAGB) has not been characterized.
This is a retrospective propensity score-matched study of ESG after LAGB at 2 centers with expertise in bariatric endoscopy. The primary outcome was total weight loss (TWL) at 12 months. Secondary outcomes included TWL at 3 and 6 months, 12-month excess weight loss (EWL), procedural characteristics, predictors of TWL, and serious adverse events.
Twenty-six adults (88.5% female, age 50.8 y, BMI 36.5 kg/m 2 ) with prior LAGB (median duration 8 y) underwent ESG at a median of 3 years after LAGB removal. A 2:1 age-matched, sex-matched, and BMI-matched comparator group was created, comprising ESG patients from the same organization and time frame but without prior LAGB. TWL for the LAGB-to-ESG cohort versus the ESG-only cohort was 10.1±5.5% versus 13.0±4.4% at 3 months ( P =0.0256), 12.4±7.2% versus 16.0±5.4% at 6 months ( P =0.0375), and 12.7±8.2% versus 18.4±6.5% at 12 months ( P =0.0149). At 12 months, the LAGB-to-ESG cohort had an EWL of 52.5±50.0%, and 75% achieved TWL ≥10%. There was no association between TWL at 3, 6, or 12 months and the following traits: age or BMI at the time of ESG, patient sex, and time from LAGB removal to ESG. No serious adverse events occurred in either cohort.
ESG after LAGB facilitates safe and clinically meaningful weight loss but is attenuated compared to primary ESG.
经腹腔镜可调节胃束带术（LAGB）治疗后的患者行内镜袖套胃成形术（ESG）的效果尚未明确。
本研究为 2 家减重内镜专业中心开展的回顾性倾向评分匹配研究，分析了 LAGB 术后行 ESG 的患者。主要结局为 12 个月时的总减重（TWL）。次要结局包括 3 个月和 6 个月时的 TWL、12 个月时的 excess weight loss（EWL）、手术特征、TWL 的预测因素以及严重不良事件。
26 例成人（88.5%为女性，年龄 50.8 岁，BMI 为 36.5kg/m 2 ）在 LAGB 去除后中位数 3 年（范围 1-5 年）行经 LAGB 后的 ESG。创建了一个 2:1 的年龄匹配、性别匹配和 BMI 匹配的对照组，包含来自同一组织和时间段但无 LAGB 病史的 ESG 患者。LAGB 至 ESG 组与 ESG 组相比，3 个月时 TWL 分别为 10.1±5.5%和 13.0±4.4%（P=0.0256），6 个月时 TWL 分别为 12.4±7.2%和 16.0±5.4%（P=0.0375），12 个月时 TWL 分别为 12.7±8.2%和 18.4±6.5%（P=0.0149）。在 12 个月时，LAGB 至 ESG 组的 EWL 为 52.5±50.0%，75%的患者达到 TWL≥10%。3 个月、6 个月或 12 个月时的 TWL 与以下特征之间没有关联：ESG 时的年龄或 BMI、患者性别以及 LAGB 去除到 ESG 的时间。两组均未发生严重不良事件。
LAGB 后行 ESG 可安全且显著减轻体重，但与原发性 ESG 相比效果减弱。
