6-Month Gastrointestinal Quality of Life (QoL) Results after Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy: A Propensity Score Analysis.
Bariatric surgery
Endoscopic sleeve gastroplasty
Quality of life
Sleeve gastrectomy
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
pubmed:
23
1
2020
medline:
15
4
2021
entrez:
23
1
2020
Statut:
ppublish
Résumé
Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed bariatric procedure. Endoscopic sleeve gastroplasty (ESG) is a promising new bariatric technique which is less invasive in its approach. To date no study has compared quality of life (QoL) outcomes between LSG and ESG. The aim of this study is to compare QoL after ESG and LSG using a propensity score analysis. QoL was evaluated by means of Gastrointestinal Quality of Life Index (GIQLI) questionnaire before and 6 months after the procedure. Patients were matched for age, sex, preoperative weight, and comorbidities. Propensity score matching resulted in 23 pairs of patients homogeneous for age (p = 0.3), preoperative BMI (p = 0.3), sex (p = 0.74), and comorbidities (p = 0.9). Post-ESG patients, despite a less important %EWL (39.9 (17.5-58.9)vs 54.9 (46.2-65); p = 0.01) and %TWL (13.4 (7.8-20.9) vs 18.8 (17.6-21.8); p = 0.03), presented better QoL (14 [3-24] vs 13 (- 1-23) ΔGIQLI score; p = 0.79) with clear advantage for the gastrointestinal symptoms subdomain (66.5 (61-70.5) vs 59 (55-63); p = 0.001), while post-LSG patients presented a worsening of GERD symptoms (30.7% vs 0%) and an increased use of PPI therapy (p = 0.004). Resolution or improvement of comorbidities was similar (ESG 53% vs LSG 45.8%; p = 0.79) in both groups. LSG may significantly affect QoL and results in worsening of gastrointestinal symptoms including GERD. ESG is a promising less invasive bariatric endoscopic procedure that demonstrated a positive impact on both QoL and comorbidities, which could lead to greater patient acceptance earlier in their disease or at a younger age.
Sections du résumé
BACKGROUND
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed bariatric procedure. Endoscopic sleeve gastroplasty (ESG) is a promising new bariatric technique which is less invasive in its approach. To date no study has compared quality of life (QoL) outcomes between LSG and ESG. The aim of this study is to compare QoL after ESG and LSG using a propensity score analysis.
METHODS
METHODS
QoL was evaluated by means of Gastrointestinal Quality of Life Index (GIQLI) questionnaire before and 6 months after the procedure. Patients were matched for age, sex, preoperative weight, and comorbidities.
RESULTS
RESULTS
Propensity score matching resulted in 23 pairs of patients homogeneous for age (p = 0.3), preoperative BMI (p = 0.3), sex (p = 0.74), and comorbidities (p = 0.9). Post-ESG patients, despite a less important %EWL (39.9 (17.5-58.9)vs 54.9 (46.2-65); p = 0.01) and %TWL (13.4 (7.8-20.9) vs 18.8 (17.6-21.8); p = 0.03), presented better QoL (14 [3-24] vs 13 (- 1-23) ΔGIQLI score; p = 0.79) with clear advantage for the gastrointestinal symptoms subdomain (66.5 (61-70.5) vs 59 (55-63); p = 0.001), while post-LSG patients presented a worsening of GERD symptoms (30.7% vs 0%) and an increased use of PPI therapy (p = 0.004). Resolution or improvement of comorbidities was similar (ESG 53% vs LSG 45.8%; p = 0.79) in both groups.
CONCLUSION
CONCLUSIONS
LSG may significantly affect QoL and results in worsening of gastrointestinal symptoms including GERD. ESG is a promising less invasive bariatric endoscopic procedure that demonstrated a positive impact on both QoL and comorbidities, which could lead to greater patient acceptance earlier in their disease or at a younger age.
Identifiants
pubmed: 31965488
doi: 10.1007/s11695-020-04419-1
pii: 10.1007/s11695-020-04419-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1944-1951Références
Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999-2008. Jama. 2010;303(3):235–41.
doi: 10.1001/jama.2009.2014
pubmed: 20071471
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany E.C., Biryukov S., Abbafati C., Abera S.F., Abraham J.P., Abu-Rmeileh N.M., Achoki T., AlBuhairan F., Alemu Z.A., Alfonso R., Ali M.K., Ali R., Guzman N.A., Ammar W., Anwari P., Banerjee A., Barquera S., Basu S., Bennett D.A., Bhutta Z., Blore J., Cabral N., Nonato I.C., Chang J.C., Chowdhury R., Courville K.J., Criqui M.H., Cundiff D.K., Dabhadkar K.C., Dandona L., Davis A., Dayama A., Dharmaratne S.D., Ding E.L., Durrani A.M., Esteghamati A., Farzadfar F., Fay D.F., Feigin V.L., Flaxman A., Forouzanfar M.H., Goto A., Green M.A., Gupta R., Hafezi-Nejad N., Hankey G.J., Harewood H.C., Havmoeller R., Hay S., Hernandez L., Husseini A., Idrisov B.T., Ikeda N., Islami F., Jahangir E., Jassal S.K., Jee S.H., Jeffreys M., Jonas J.B., Kabagambe E.K., Khalifa S.E., Kengne A.P., Khader Y.S., Khang Y.H., Kim D., Kimokoti R.W., Kinge J.M., Kokubo Y., Kosen S., Kwan G., Lai T., Leinsalu M., Li Y., Liang X., Liu S., Logroscino G., Lotufo P.A., Lu Y., Ma J., Mainoo N.K., Mensah G.A., Merriman T.R., Mokdad A.H., Moschandreas J., Naghavi M., Naheed A., Nand D., Narayan K.M., Nelson E.L., Neuhouser M.L., Nisar M.I., Ohkubo T., Oti S.O., Pedroza A., Prabhakaran D., Roy N., Sampson U., Seo H., Sepanlou S.G., Shibuya K., Shiri R., Shiue I., Singh G.M., Singh J.A., Skirbekk V., Stapelberg N.J., Sturua L., Sykes B.L., Tobias M., Tran B.X., Trasande L., Toyoshima H., van de Vijver S., Vasankari T.J., Veerman J.L., Velasquez-Melendez G., Vlassov V.V., Vollset S.E., Vos T., Wang C., Wang X., Weiderpass E., Werdecker A., Wright J.L., Yang Y.C., Yatsuya H., Yoon J., Yoon S.J., Zhao Y., Zhou M., Zhu S., Lopez A.D., Murray C.J., Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014 Aug 30;384(9945):766–781. Pubmed Central PMCID: PMC4624264.
Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009 Sep;13(41):1. -190, 215-357, iii-iv
Kim DD, Basu A. Estimating the medical care costs of obesity in the United States: systematic review, meta-analysis, and empirical analysis. Value Health. 2016 Jul-Aug;19(5):602–13.
doi: 10.1016/j.jval.2016.02.008
pubmed: 27565277
Livingston EH, Fink AS. Quality of life: cost and future of bariatric surgery. Arch Surg. 2003 Apr;138(4):383–8.
doi: 10.1001/archsurg.138.4.383
pubmed: 12686524
McVinnie DS. Obesity and pain. Br J Pain 2013 Nov;7(4):163–170. Pubmed Central PMCID: PMC4590160.
pubmed: 4590160
pmcid: 4590160
doi: 10.1177/2049463713484296
Abiles V, Rodriguez-Ruiz S, Abiles J, et al. Psychological characteristics of morbidly obese candidates for bariatric surgery. Obes Surg. 2010 Feb;20(2):161–7.
doi: 10.1007/s11695-008-9726-1
pubmed: 18958537
van Hout GC, Verschure SK, van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005 Apr;15(4):552–60.
doi: 10.1381/0960892053723484
pubmed: 15946437
Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013 Oct 22;347:f5934. PubMed PMID: 24149519. Pubmed Central PMCID: PMC3806364
pubmed: 3806364
pmcid: 3806364
doi: 10.1136/bmj.f5934
Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012 Apr 26;366(17):1577–85.
doi: 10.1056/NEJMoa1200111
pubmed: 22449317
Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015 Sep 5;386(9997):964–73.
doi: 10.1016/S0140-6736(15)00075-6
Dixon JB, Dixon ME, O'Brien PE. Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Obes Res. 2001 Nov;9(11):713–21.
doi: 10.1038/oby.2001.96
pubmed: 11707538
Herpertz S, Kielmann R, Wolf A, et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12(10):1554–69.
doi: 10.1038/oby.2004.195
pubmed: 15536219
Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2
Alsumali A, Eguale T, Bairdain S, et al. Cost-effectiveness analysis of bariatric surgery for morbid obesity. Obes Surg. 2018 Aug;28(8):2203–14.
doi: 10.1007/s11695-017-3100-0
pubmed: 29335933
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015 Oct;25(10):1822–32.
doi: 10.1007/s11695-015-1657-z
pubmed: 25835983
Boza C, Daroch D, Barros D, et al. Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1129–33.
doi: 10.1016/j.soard.2014.03.024
pubmed: 25500284
Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett's esophagus after laparoscopic sleeve Gastrectomy: long-term follow-up. Obes Surg. 2017 Dec;27(12):3092–101.
doi: 10.1007/s11695-017-2748-9
pubmed: 28593484
Peterli R, Wolnerhanssen BK, Peters T, Vetter D, Kroll D, Borbely Y, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018 Jan 16;319(3):255–265. Pubmed Central PMCID: PMC5833546.
pubmed: 5833546
pmcid: 5833546
doi: 10.1001/jama.2017.20897
Overs SE, Freeman RA, Zarshenas N, et al. Food tolerance and gastrointestinal quality of life following three bariatric procedures: adjustable gastric banding, roux-en-Y gastric bypass, and sleeve gastrectomy. Obes Surg. 2012 Apr;22(4):536–43.
doi: 10.1007/s11695-011-0573-0
pubmed: 22170392
Imbus JR, Voils CI, Funk LM. Bariatric surgery barriers: a review using Andersen's model of health services use. Surg Obes Relat Dis 2018 Mar;14(3):404–412. Pubmed Central PMCID: PMC6039385.
doi: 10.1016/j.soard.2017.11.012
Saber AA, Shoar S, Almadani MW, et al. Efficacy of first-time intragastric balloon in weight loss: a systematic review and meta-analysis of randomized controlled trials. Obes Surg. 2017 Feb;27(2):277–87.
doi: 10.1007/s11695-016-2296-8
pubmed: 27465936
Sharaiha RZ, Kumta NA, Saumoy M, et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol. 2017;15(4):504–10.
doi: 10.1016/j.cgh.2016.12.012
pubmed: 28017845
Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. Jama. 2018;319(3):241–54.
pubmed: 5833550
pmcid: 5833550
doi: 10.1001/jama.2017.20313
Aurora AR, Khaitan L, Saber AA. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surg Endosc. 2012 Jun;26(6):1509–15.
doi: 10.1007/s00464-011-2085-3
pubmed: 22179470
Rebecchi F, Allaix ME, Giaccone C, et al. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation. Ann Surg. 2014 Nov;260(5):909–14. discussion 14-5
doi: 10.1097/SLA.0000000000000967
Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013 Sep;78(3):530–5.
doi: 10.1016/j.gie.2013.04.197
pubmed: 23711556
Braghetto I, Lanzarini E, Korn O, et al. Manometric changes of the lower esophageal sphincter after sleeve gastrectomy in obese patients. Obes Surg. 2010 Mar;20(3):357–62.
doi: 10.1007/s11695-009-0040-3
pubmed: 20013071
Schweiger C, Weiss R, Keidar A. Effect of different bariatric operations on food tolerance and quality of eating. Obes Surg. 2010 Oct;20(10):1393–9.
doi: 10.1007/s11695-010-0233-9
pubmed: 20680506
Soricelli E, Casella G, Baglio G, et al. Lack of correlation between gastroesophageal reflux disease symptoms and esophageal lesions after sleeve gastrectomy. Surg Obes Relat Dis. 2018;14(6):751–6.
doi: 10.1016/j.soard.2018.02.008
pubmed: 29571635
Oor JE, Roks DJ, Unlu C, et al. Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Surg. 2016 Jan;211(1):250–67.
doi: 10.1016/j.amjsurg.2015.05.031
pubmed: 26341463
Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017 Apr;13(4):568–74.
doi: 10.1016/j.soard.2016.11.029
pubmed: 28089434
Lim CH, Lee PC, Lim E, et al. Correlation between symptomatic gastro-esophageal reflux disease (GERD) and erosive esophagitis (EE) post-vertical sleeve gastrectomy (VSG). Obes Surg. 2019;29(1):207–14.
doi: 10.1007/s11695-018-3509-0
pubmed: 30238218
Gagner M, Hutchinson C, Rosenthal R. Fifth international consensus conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016 May;12(4):750–6.
doi: 10.1016/j.soard.2016.01.022
pubmed: 27178618
Fayad L, Adam A, Schweitzer M, et al. Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc. 2019 Apr;89(4):782–8.
pubmed: 30148991
pmcid: 30148991
doi: 10.1016/j.gie.2018.08.030
Hamoui N, Anthone GJ, Kaufman HS, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006 Nov;16(11):1445–9.
doi: 10.1381/096089206778870157
pubmed: 17132409
Himpens J, Dapri G, Cadière GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.
doi: 10.1381/096089206778869933
pubmed: 17132410
Klaus A, Weiss H. Is preoperative manometry in restrictive bariatric procedures necessary? Obes Surg. 2008;18(8):1039–42.
doi: 10.1007/s11695-007-9399-1
pubmed: 18386106
Novikov AA, Afaneh C, Saumoy M, et al. Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic band for weight loss: how do they compare? J Gastrointest Surg. 2018;22(2):267–73.
pubmed: 29110192
pmcid: 29110192
doi: 10.1007/s11605-017-3615-7
D’Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.
doi: 10.1007/s00464-011-1572-x
pubmed: 21359900
Strain GW, Saif T, Gagner M, et al. Cross-sectional review of effects of laparoscopic sleeve gastrectomy at 1, 3, and 5 years. Surg Obes Relat Dis. 2011;7(6):714–9.
doi: 10.1016/j.soard.2011.08.021
pubmed: 22014484
Borisenko O, Lukyanov V, Ahmed AR. Cost-utility analysis of bariatric surgery. Br J Surg. 2018 Sep;105(10):1328–37.
doi: 10.1002/bjs.10857
pubmed: 29667178
Glass J, Chaudhry A, Zeeshan MS, Ramzan Z. New era: endoscopic treatment options in obesity-a paradigm shift. World J Gastroenterol 2019 Aug 28;25(32):4567–4579. Pubmed Central PMCID: PMC6718037.
pubmed: 6718037
pmcid: 6718037
doi: 10.3748/wjg.v25.i32.4567