Studies: Endoscopic Approaches to Weight Loss Safe, Effective

Endoscopic approaches to gastric remodeling are safe and effective ways to induce long-term weight loss, according to the results of 2 recent studies.

The first study aimed to evaluate the safety and efficacy of endoscopic sleeve gastroplasty (ESG), a potentially reversible and minimally invasive option for bariatric treatment.¹

The researchers conducted a 3-center study of medical records from 242 patients who underwent ESG from January 2013 to November 2015. The researchers assessed total body weight loss using multivariate linear and logistic regression analyses. Baseline body mass index was 37.8 ± 5.5 kg/m².
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Overall, 5 serious adverse events occurred: 2 perigastric inflammatory fluid collections, 1 self-limited hemorrhage from splenic laceration, 1 pulmonary embolism, and 1 pneumoperitoneum and pneumothorax requiring chest tube placement.

Percent total body weight loss was 16.8 ± 6.4 at six months, 18.2 ± 10 at one year, and 19.8 ± 11.6 at 18 months. After 18 months, 66.7% of participants sustained ≥15% total body weight loss.

In the second study, the researchers assessed the safety and efficacy of the Articulated Circular Endoscopic stapler when used to create plications of the greater gastric curve for the treatment of obesity.²

They analyzed data from a premarket, prospective, multicenter, nonrandomized, pilot study involving 69 participants with initial weight of 102 ± 18 kg and a body mass index of 38 ± 4 kg/m².

During 24 months of follow-up, 239 mild or moderate adverse events occurred, including abdominal pain, oropharyngeal pain, nausea, and constipation.

Among the 45 patients available for 24 months of follow-up, mean excess weight loss was 21%. Twenty-two of the 45 shifted to a lower obesity class, 20 remained the same, and 3 shifted to a higher class. Quality of life, measured using the Short Form-36 questionnaire, significantly improved in 5 of 8 domains at 12 months and 3 of 8 domains at 24 months.

—Michael Potts

References:

1. Lopez-Nava G, Sharaiha RZ, Galvao M, et al. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 242 patients with 18 months follow-up. Presented at Digestive Disease Week. May 21, 2016. San Diego, California.
2. Biertho L, Lebel S, Hould F, et al. Open, prospective study to evaluate the safety and preliminary effectiveness of the ACE™ stapler for the treatment of obesity. Presented at Digestive Disease Week. May 22, 2016. San Diego, California.