From Early to Mid-Term Results of Endoscopic Sleeve Gastroplasty: A Retrospective Analysis of a Bariatric Center.

Abstract

Global obesity rates have surged, necessitating effective interventions beyond traditional bariatric and metabolic surgery (BMS). Endoscopic Sleeve Gastroplasty (ESG) has emerged as a minimally invasive alternative, addressing limitations of eligibility criteria and patient reluctance associated with BMS. This study aims to present a 3-year experience with ESG, focusing on its mid-term efficacy in weight loss. A retrospective, single-center study included 143 consecutive ESG patients (BMI > 30kg/m2 or > 25kg/m2 with obesity associated-diseases) from February 2019 to March 2023. Data on demographics, comorbidities, operative details, and follow-up outcomes were collected. The primary outcome was %TWL ≥ 15% at 12months. Secondary outcomes were an optimal clinical response (OCR) at 24 and 36months defined by %TWL ≥ 10% or %EWL ≥ 25%. ESG demonstrated a mean %TWL of 14.37% at 12months, aligning with previous studies. Early postoperative complications were minimal (2.1%), with no mortality. Follow-up revealed a peak in weight loss at 9months, but mid-term OCR was achieved in 41.2% at 3years. The learning curve showed efficiency improvements after 26 procedures. ESG proves effective at one year, with a %TWL of 14.37%. However, mid-term efficacy beyond 12months remains challenging, raising questions about the durability of weight loss. Despite a low complication rate, strategies for maintaining a long-term OCR, including potential repeat ESG, warrant further investigation.