Journal ArticleDOI
Endoscopic Sleeve Gastroplasty for Obesity: a Multicenter Study of 248 Patients with 24 Months Follow-Up.
Gontrand Lopez-Nava,Reem Z. Sharaiha,Eric J. Vargas,Fateh Bazerbachi,Galvao Neto Manoel,Inmaculada Bautista-Castaño,Andres Acosta,Mark Topazian,Manpreet S. Mundi,Nikhil A. Kumta,Michel Kahaleh,Andrea Herr,Alpana P. Shukla,Louis J. Aronne,Christopher J. Gostout,Barham K. Abu Dayyeh +15 more
TLDR
ESG effectively induces weight loss up to 24 months in moderately obese patients and failure to achieve adequate weight loss can be predicted early, and patients should be offered adjunctive therapies to augment it.Abstract:
Endoscopic sleeve gastroplasty (ESG) is a technique for managing mild to moderately obese patients. We aimed to evaluate the long-term outcomes, reproducibility, and predictors of weight response in a large multicenter cohort. Patients who underwent ESG between January 2013 and December 2015 in three centers were retrospectively analyzed. All procedures were performed using the Apollo OverStitch device (Apollo Endosurgery, Austin, TX). We performed per protocol (PP) and intention-to-treat (ITT) analyses, where patients lost to follow-up were considered failures. Multivariable linear and logistic regression analyses were performed. We included 248 patients (mean age 44.5 ± 10 years, 73% female). Baseline BMI was 37.8 ± 5.6 kg/m2. At 6 and 24 months, 33 and 35 patients were lost to follow-up, respectively. At 6 and 24 months, %TBWL was 15.2 [95%CI 14.2–16.3] and 18.6 [15.7–21.5], respectively. Weight loss was similar between centers at both follow-up intervals. At 24 months, % of patients achieving ≥10% TBWL was 84.2 and 53% with PP and ITT analyses, respectively. On multivariable linear regression analysis, only %TBWL at 6 months strongly predicted %TBWL at 24 months (adjusted for age, gender, and baseline BMI, β = 1.21, p < 0.001). The odds of achieving ≥10%TBWL at 24 months if a patient achieved <10%TBWL at 6 months is 0.18 [0.034–0.84]. Five (2%) serious adverse events occurred. ESG effectively induces weight loss up to 24 months in moderately obese patients. Failure to achieve adequate weight loss can be predicted early, and patients should be offered adjunctive therapies to augment it.read more
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Journal ArticleDOI
Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored by american association of clinical endocrinologists/american college of endocrinology, the obesity society, american society for metabolic & bariatric surgery, obesity medicine association, and american society of anesthesiologists*
Jeffrey I. Mechanick,Caroline M. Apovian,Stacy A. Brethauer,W. Timothy Garvey,Aaron M. Joffe,Julie Kim,Robert F. Kushner,Richard Lindquist,Rachel Pessah-Pollack,Jennifer Seger,Richard D. Urman,Stephanie Adams,John B. Cleek,Riccardo Correa,M. Kathleen Figaro,Karen Flanders,Jayleen Grams,Daniel L. Hurley,Shanu N. Kothari,Michael V. Seger,Christopher D. Still +20 more
TL;DR: These updated clinical practice guidelines for bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity and clinical decision-making should be evidence-based within the context of a chronic disease.
Journal ArticleDOI
Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists.
Jeffrey I. Mechanick,Jeffrey I. Mechanick,Caroline M. Apovian,Stacy A. Brethauer,W. Timothy Garvey,W. Timothy Garvey,Aaron M. Joffe,Julie Kim,Robert F. Kushner,Richard Lindquist,Rachel Pessah-Pollack,Jennifer Seger,Richard D. Urman,Stephanie Adams,John B. Cleek,Riccardo Correa,M. Kathleen Figaro,Karen Flanders,Jayleen Grams,Jayleen Grams,Daniel L. Hurley,Shanu N. Kothari,Michael V. Seger,Christopher D. Still +23 more
TL;DR: Bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity and clinical decision-making should be evidence-based within the context of a chronic disease.
Journal ArticleDOI
Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists
Jeffrey I. Mechanick,Caroline M. Apovian,Stacy A. Brethauer,W. Timothy Garvey,Aaron M. Joffe,Julie Kim,Robert F. Kushner,Richard Lindquist,Rachel Pessah-Pollack,Jennifer Seger,Richard D. Urman,Stephanie Adams,John B. Cleek,Riccardo Correa,M. Kathleen Figaro,Karen Flanders,Jayleen Grams,Daniel L. Hurley,Shanu N. Kothari,Michael V. Seger,Christopher D. Still +20 more
TL;DR: The updated clinical practice guidelines (CPGs) were developed by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists as mentioned in this paper.
Journal ArticleDOI
Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients
Aayed R. Alqahtani,Abdullah Al-Darwish,Ahmed Elsayed Mahmoud,Yara A Alqahtani,Mohamed Elahmedi +4 more
TL;DR: Weight loss, morbidity, revisions, and comorbidity resolution during the first 18 months after primary ESG appears to be well tolerated, safe, and effective.
Journal ArticleDOI
Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption: a Large, International Multicenter Study
Adrian Sartoretto,Zhixian Sui,Christine Hill,Margo Dunlap,Angielyn R Rivera,Mouen A. Khashab,Anthony N. Kalloo,Lea Fayad,Lawrence J. Cheskin,George Marinos,Erik B Wilson,Vivek Kumbhari +11 more
TL;DR: Multivariable analysis showed that male sex, greater baseline body weight, and lack of prior endoscopic bariatric therapy were predictors of greater Δweight at 6 months, suggesting ESG is an effective, reproducible, and safe weight loss therapy that is suitable for widespread clinical adoption.
References
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