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Espinet-Coll E, Nebreda-Durán J, Galvao-Neto M, Bautista-Altamirano C, Diaz-Galán P, Gómez-Valero JA, Vila-Lolo C, Guirola-Puche MA, Fernández-Huélamo A, Bargalló-Carulla D, Juan-Creix Comamala A. Suture pattern does not influence outcomes of endoscopic sleeve gastroplasty in obese patients. Endosc Int Open 2020; 8:E1349-E1358. [PMID: 33015337 PMCID: PMC7508658 DOI: 10.1055/a-1221-9835] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/12/2020] [Indexed: 02/08/2023] Open
Abstract
Background and study aims ESG is an effective and safe medium-term procedure for obesity treatment. A variety of suture patterns have been reported. We aimed to compare whether there are differences in efficacy depending on suture pattern used. Patients and methods Retrospective and comparative review of 5 years of prospectively collected data, including consecutive obese patients undergoing ESG at two collaborative centers. Primary outcomes included weight loss (mainly % total body weight loss [TBWL] and % exces weight loss [EWL]) at 12 months and safety profile. We compared them according to three suture patterns (transverse bilinear [TBp], longitudinal [Lp] and transverse monolinear [TMp]), and number of sutures (4 - 7) and stitches (< 25, 25 to 30 and > 30) applied. Evolution of major obesity-associated morbidities (hypertension, dyslipidemia, Type 2 diabetes mellitus (T2DM), sleep obstructive apnea syndrome, and arthropathy) were also described. Results 88 patients (mean age 46.1±12.3 years, 69.3 % female) underwent ESG. Mean body mass index (BMI) at baseline was 39.40 ± 4.69 kg/m². At 1 year, %TBWL was 17.36 ± 6.09 % (%EWL 46.41±20.6 %) with TBWL > 10 % in 95.5 % of patients (EWL > 25 % in 94.3 % of patients). According to pattern, there were no differences in %TBWL but there were in %EWL (43.7 ± 20.4 %, 59.8 ± 18.9 % and 45.4 ± 14.9 % in TBp, Lp and TMp patterns, respectively) ( P = 0.034). No differences were found related to number of sutures (mean 5.2 ± 0.73, r = 4 - 7) or stitches (mean 27.4 ± 6.50, r = 18 - 50) applied. Forty-three of 72 (59.7 %) major comorbidities were resolved. No serious adverse events were observed with any pattern. Conclusions ESG is an effective procedure at 12-month follow-up for weight loss and comorbidity resolution. All three analyzed patterns are safe and effective without differences in %TBWL, but there was a slight increase in %EWL in Lp, regardless of the number of sutures or stitches applied.
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Affiliation(s)
- E. Espinet-Coll
- Bariatric Endoscopy Unit. Dexeus University Hospital, Barcelona, Spain,Bariatric Endoscopy Unit. Endosmedicina, Diagonal Clinic, Barcelona, Spain
| | - J. Nebreda-Durán
- Bariatric Endoscopy Unit. Endosmedicina, Diagonal Clinic, Barcelona, Spain
| | - M. Galvao-Neto
- Endovitta, Sao Paolo, Brazil and Florida International University, Miami, United States
| | | | - P. Diaz-Galán
- Bariatric Endoscopy Unit. Dexeus University Hospital, Barcelona, Spain
| | | | - C. Vila-Lolo
- Bariatric Endoscopy Unit. Dexeus University Hospital, Barcelona, Spain
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