Outcomes of Endoscopic Sleeve Gastroplasty Following Laparoscopic Adjustable Gastric Band: A Propensity Score-matched Analysis.
Journal
Surgical laparoscopy, endoscopy & percutaneous techniques
ISSN: 1534-4908
Titre abrégé: Surg Laparosc Endosc Percutan Tech
Pays: United States
ID NLM: 100888751
Informations de publication
Date de publication:
13 Feb 2024
13 Feb 2024
Historique:
received:
06
10
2023
accepted:
01
12
2023
medline:
15
2
2024
pubmed:
15
2
2024
entrez:
15
2
2024
Statut:
aheadofprint
Résumé
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/m2) 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.
Sections du résumé
BACKGROUND
BACKGROUND
The performance of endoscopic sleeve gastroplasty (ESG) in patients with prior laparoscopic adjustable gastric band (LAGB) has not been characterized.
MATERIALS AND METHODS
METHODS
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.
RESULTS
RESULTS
Twenty-six adults (88.5% female, age 50.8 y, BMI 36.5 kg/m2) 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.
CONCLUSION
CONCLUSIONS
ESG after LAGB facilitates safe and clinically meaningful weight loss but is attenuated compared to primary ESG.
Identifiants
pubmed: 38359348
doi: 10.1097/SLE.0000000000001265
pii: 00129689-990000000-00205
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
C.E.M.: former consultant for Apollo Endosurgery, and has received honoraria for educational consulting. D.B.M.: consultant for Apollo Endosurgery, and has received honoraria for educational consulting. The remaining authors declare no conflicts of interest.
Références
Benson-Davies S, Rogers AM, Huberman W, et al. American Society of Metabolic and Bariatric Surgery consensus statement on laparoscopic adjustable gastric band management. Surg Obes Relat Dis. 2022;18:1120–1133.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery Survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg. 2021;31:1937–1948.
Carandina S, Genser L, Bossi M, et al. Laparoscopic sleeve gastrectomy after failed gastric banding: is it really effective? Six years of follow-up. Surg Obes Relat Dis. 2017;13:1165–1173.
Clapp B, Harper B, Dodoo C, et al. Trends in revisional bariatric surgery using the MBSAQIP database 2015-2017. Surg Obes Relat Dis. 2020;16:908–915.
Rohner A, Widmer JD, Klasen J, et al. Long-term outcomes of gastric band removal without additional bariatric surgery. Surg Obes Relat Dis. 2017;13:261–266.
Bray GA, Kim KK, Wilding JPH, et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017;18:715–723.
Tan MHL, Yee GYW, Jorgensen JO, et al. A histologic evaluation of the laparoscopic adjustable gastric band capsule by tissue sampling during sleeve gastrectomy performed at different time points after band removal. Surg Obes Relat Dis. 2014;10:620–625.
Eid I, Birch DW, Sharma AM, et al. Complications associated with adjustable gastric banding for morbid obesity: a surgeon’s guides. Can J Surg. 2011;54:61–66.
Lim R, Beekley A, Johnson DC, et al. Early and late complications of bariatric operation. Trauma Surg Acute Care Open. 2018;3:e000219.
Lazzati A, Bechet S, Jouma S, et al. Revision surgery after sleeve gastrectomy: a nationwide study with 10 years of follow-up. Surg Obes Relat Dis. 2020;16:1497–1504.
James TW, Sheikh SZ, McGowan CE. Perigastric abscess as a delayed adverse event in endoscopic sleeve gastroplasty. Gastrointest Endosc. 2019;89:890–891.
James TW, McGowan CE. The descending gastric fundus in endoscopic sleeve gastroplasty: implications for procedural technique and adverse events. VideoGIE. 2019;4:254–255.
Lopez-Nava G, Asokkumar R, Negi A, et al. Re-suturing after primary endoscopic sleeve gastroplasty (ESG) for obesity. Surg Endosc. 2021;35:2523–2530.
Maselli DB, Waseem A, Lee D, et al. Performance characteristics of endoscopic sleeve gastroplasty in patients with prior intragastric balloon: results of a propensity score matched study. Obes Surg. 2023;33:2711–2717.
Drakos P, Volteas P, Khomutova A, et al. The durability of revisional sleeve gastrectomy and Roux-en-Y gastric bypass after previous adjustable gastric band. Surg Endosc. 2023;37:2326–2334.
Huang BW, Shahul SS, Ong MKH, et al. Medium term outcomes of revision laparoscopic sleeve gastrectomy after gastric banding: a propensity score matched study. Obes Surg. 2023;33:2005–2015.
James TW, Reddy S, Vulpis T, et al. Endoscopic sleeve gastroplasty is feasible, safe, and effective in a non-academic setting: short-term outcomes from a community gastroenterology practice. Obes Surg. 2020;30:1404–1409.
Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010;71:446–454.
Sarkar A, Tawadros A, Andalib I, et al. Safety and efficacy of endoscopic sleeve gastroplasty for obesity management in new bariatric endoscopy programs: a multicenter international study. Ther Adv Gastrointest Endosc. 2022;15:26317745221093884.
Maselli DB, Hoff AC, Kucera A, et al. Endoscopic sleeve gastroplasty in class III obesity: efficacy, safety, and durability outcomes in 404 consecutive patients. World J Gastrointest Endosc. 2023;15:469–479.
Rapaka B, Maselli DB, Lopez-Nava G, et al. Effects on physiologic measures of appetite from intragastric balloon and endoscopic sleeve gastroplasty: results of a prospective study. Chin Med J (Engl). 2022;135:1234–1241.
Vargas EJ, Rizk M, Gomez-Villa J, et al. Effect of endoscopic sleeve gastroplasty on gastric emptying, motility and hormones: a comparative prospective study. Gut. 2022;72:1073–1080.
Abu Dayyeh BK, Acosta A, Camilleri M, et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol. 2017;15:37–43.e1.
Clapp B, Wynn M, Martyn C, et al. Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis. Surg Obes Relat Dis. 2018;14:741–747.
Silecchia G, Rizzello M, Angelis F De, et al. Laparoscopic sleeve gastrectomy as a revisional procedure for failed laparoscopic gastric banding with a “2-step approach”: a multicenter study. Surg Obes Relat Dis. 2014;10:626–631.
Alqahtani AR, Elahmedi MO, Qahtani AR Al, et al. 5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:1769–1776.
Barrett AM, Vu KT, Sandhu KK, et al. Primary sleeve gastrectomy compared to sleeve gastrectomy as revisional surgery: weight loss and complications at intermediate follow-up. J Gastrointest Surg. 2014;18:1737–1743.
Farha J, McGowan C, Hedjoudje A, et al. Endoscopic sleeve gastroplasty: suturing the gastric fundus does not confer benefit. Endoscopy. 2021;53:727–731.
Ryan DH, Yockey SR. Weight loss and improvement in comorbidity: differences at 5%, 10%, 15%, and over. Curr Obes Rep. 2017;6:187–194.
Abu Dayyeh BK, Kumar N, et alASGE Bariatric Endoscopy Task Force and ASGE Technology Committee. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82:425–38.e5.