Endoscopic sleeve gastroplasty as an early tool against obesity: a multicenter international study on an overweight population

Abstract

Background and aimsEndoscopic sleeve gastroplasty (ESG) is an effective, minimally invasive gastric remodeling procedure to treat mild and moderate obesity. Early adoption of ESG may be desirable to try to halt progression of obesity, but there are few data on efficacy and safety for overweight patients. MethodsThis was a multicenter, international, analytical case series. Six American, one Brazilian, one Mexican, and one Indian center were included. Overweight patients according to local practice undergoing ESG were considered eligible for the study. The endpoints were %total weight loss (%TWL), BMI reduction, rate of BMI normalization, and adverse events rate (AEs). ResultsOne hundred eighty-nine patients with a mean age of 42.6±14.1 years old and a mean BMI of 27.79±1.17kg/m2 were included. All procedures were successfully accomplished and there were 3 intraprocedural AEs (1.5%). The mean %TWL was 12.28±3.21%, 15.03±5.30%, 15.27±5.28%, and 14.91±5.62% at 6, 12, 24, and 36 months, respectively. At 12 and 24 months, 76% and 86% of patients achieved normal BMI with a mean BMI reduction of 4.13±1.46kg/m2 and 4.25±1.58kg/m2. There was no difference in mean %TWL of the first quartile versus the fourth quartile of BMI in any of the time points. However, the BMI normalization rate was statistically higher in the first group at 6 and 12 months (6m: 100% vs. 48.5%, p<0.01; 12m: 86.2% vs. 50%, p<0.01; 24m: 84.6% vs. 76.1%, p=0.47; 36m: 86.3% vs. 66.6%, p=0.26). ConclusionESG is safe and effective in treating overweight patients with high BMI normalization rates. It could help halt or delay the progression to obesity.