Sa1933 ENDOSCOPIC SLEEVE GASTROPLASTY IN THE MANAGEMENT OF WEIGHT REGAIN AFTER SLEEVE GASTRECTOMY

Abstract

Sleeve gastrectomy (SG) has become a well-standardized surgical treatment option for obesity. However, the rate of weight regain (WR) after SG in long-term follow-up is relatively high. This multicenter study is the first to evaluate the use of an Endoscopic Sleeve Gastroplasty (ESG) technique for the management of WR after SG including patients with overweight-obesity across the full BMI spectrum. This is a multicenter retrospective study, including patients with WR following SG who underwent ESG for weight loss. The primary outcomes included AWL, %TWL, change in BMI, %EWL at 6 and 12 months in patients with overweight or obesity, and safety profile. Clinical success was defined as achieving ≥25% EWL at 1-year with ≤5% serious adverse event (SAE) rate following the ASGE/ASMBS threshold, and %TWL>10%. Thirty-four patients underwent ESG after SG. Technical success was 100%. At 1 year, 82.35% and 100% of patients achieved >10%TWL and >25% EWL, respectively. On avarage, %TWL was 13.2±3.9 and 18.3±5.5 and %EWL was 51.9±19.1and 69.9±29.9 at 6 months and 1-year, respectively (Table 1). %TWL was 14.2 ± 12.5, 19.3 ± 5.3, 17.5 ± 5.2, and 20.4 ± 3.3, and %EWL was 88.5±52.8, 84.4±22.4, 55.4±14.8, and 47.8±11.2 for overweight, obesity class I, II, and III, respectively at 1-year follow-up (Figures 1). No predictors of success were identified in the multivariable regression analysis. No SAE were reported. Given a rise in the number of sleeve gastrectomy being performed worldwide, there is an increasing demand for a minimally invasive endoscopic treatment option for weight regain following SG. Considering the minimally invasive outpatient nature of ESG, the reproducibility among centers, the low prevalence of SAE, and the favorable clinical outcomes, ESG following SG appears to be safe and effective and may offer a solution for the treatment of this challenging patient population.Figure 1Comparison between %TWL at 3, 6, 9 and 12 months follow-up in all BMI subgroupsView Large Image Figure ViewerDownload Hi-res image Download (PPT)