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Kozłowska-Petriczko K, Pawlak KM, Wojciechowska K, Reiter A, Błaszczyk Ł, Szełemej J, Petriczko J, Wiechowska-Kozłowska A. The Efficacy Comparison of Endoscopic Bariatric Therapies: 6-Month Versus 12-Month Intragastric Balloon Versus Endoscopic Sleeve Gastroplasty. Obes Surg 2023; 33:498-505. [PMID: 36525237 PMCID: PMC9889469 DOI: 10.1007/s11695-022-06398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Intragastric balloon (IGB) insertion and endoscopic sleeve gastroplasty (ESG) are known to be effective and safe in achieving weight loss. The aim of this study was to compare the effects of a 6-month IGB therapy, a 12-month IGB therapy, and ESG. METHODS We retrospectively analyzed the weight loss at IGB (Orbera) removal after 6 months (124 patients), at IGB (Orbera365) removal after 12 months (61 patients) and at 6 and 12 months after ESG (42 and 34 patients, respectively). Postprocedural care, including medication and diet, was the same for all procedures. RESULTS Mean TBWL in patients undergoing IGB placement for 6 and 12 months and ESG after 6 and 12 months were 15.2, 15.8, 26.5, and 28.7 kg, respectively. There was no significant difference in the mean %TBWL in patients undergoing IGB placement for 6 or for 12 months (15.3% vs. 14.7%, P = 0.7). ESG patients showed a significantly higher mean %TBWL than IGB patients after 6 months (15.3 vs. 19.8, P = 0.005) and 12 months (14.7 vs. 22.5, P < 0.001). CONCLUSION All three studied methods were effective for achieving weight loss. However, there was no significant difference between 6-month and 12-month IGB therapies outcomes. ESG appeared to be a more effective obesity treatment modality than IGB.
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Affiliation(s)
| | - K M Pawlak
- Endoscopy Unit, Department of Gastroenterology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - K Wojciechowska
- Department of Internal Medicine and Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - A Reiter
- Endoscopy Unit, Regional Health Center, Lubin, Poland
| | - Ł Błaszczyk
- Endoscopy Unit, Sonomed Medical Centre, Szczecin, Poland
| | - J Szełemej
- Endoscopy Unit, Regional Health Center, Lubin, Poland
| | - J Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, Szczecin, Poland
| | - A Wiechowska-Kozłowska
- Endoscopy Unit, Department of Gastroenterology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
- Endoscopy Unit, Sonomed Medical Centre, Szczecin, Poland
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Seleq S, Khan R, Gimpaya N, Vargas JI, Amin S, Bilal M, Bollipo S, Charabaty A, de-Madaria E, Hashim A, Kral J, Pawlak KM, Sandhu DS, Lui RN, Sanchez-Luna S, Siau K, Mosko J, Grover S. A32 DEVELOPMENT AND VALIDATION OF THE TORONTO UPPER GASTROINTESTINAL CLEANING SCORE. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859122 DOI: 10.1093/jcag/gwab049.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
High quality esophagogastroduodenoscopy (EGD) depends on the ability to appropriately visualize upper gastrointestinal (GI) mucosa pathology. Evaluation can be limited by the presence of mucus, foam, bubbles and solid materials. Currently, there is no standardized method to assess mucosal visualization for use in clinical or research settings.
Aims
To develop and establish the content validity of the Toronto Upper Gastrointestinal Cleaning Score (TUGCS) and evaluate its interrater reliability.
Methods
An international panel of endoscopy experts rated potential items and their associated anchors for importance as indicators of adequacy of mucosal visualization during EGD. The survey utilized a Likert scale (1 (strongly disagree) to 5 (strongly agree)). The Delphi process was repeated until consensus was reached. Consensus was defined priori as ≥80% of experts in a given round scoring ≥4 on all survey items. To assess content validity, 48 EGD procedures were evaluated in real-time by two endoscopist reviewers using the TUGCS at a single institution. The interrater agreement between assessments was calculated for TUGCS total scores using intraclass correlation coefficient, one-way random effects model (ICC 1,1).
Results
Fourteen experts agreed to be part of the Delphi panel. An anatomical framework representing the upper GI mucosa and anchors for each mucosal portion representing various levels of visibility was generated through systematic review. Three survey rounds, with response rates of 100%, 100% and 71% respectively, achieved consensus. The final TUGCS includes four anatomical areas (fundus, body, antrum, duodenum) and mucosal visualization anchors ranging from 0 to 3 (Figure 1). TUGCS was used to assess foregut cleaning in 48 procedures (Table 1). The mean TUGCS for staff and trainee were 8.1 (±2.4) and 8.1 (±2.6), respectively. The ICC was 0.78 (95% confidence interval 0.62–0.88) indicating good reliability.
Conclusions
We developed and generated content validity evidence for the TUGCS through rigorous Delphi methodology, reflective of practice across different centres. Planned as future research is a video survey distributed to endoscopists internationally to further validate the TUGCS to create a tool that may be used to judge mucosal visualization for EGD in research and clinical settings.
Funding Agencies
None
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Affiliation(s)
- S Seleq
- St Michael’s Hospital, Toronto, ON, Canada
| | - R Khan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - N Gimpaya
- St Michael’s Hospital, Toronto, ON, Canada
| | - J I Vargas
- Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - S Amin
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, Miami, FL
| | - M Bilal
- Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, Boston, MA
| | - S Bollipo
- Gastroenterology Department, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia, Newcastle, New South Wales, Australia
| | - A Charabaty
- Division of Gastroenterology, Johns Hopkins-Sibley Memorial Hospital, Washington, DC, Washington, DC
| | - E de-Madaria
- Alicante University General Hospital, Alicante Institute for Health and Biomedical Research, Alicante, Spain, Alicante, Spain
| | - A Hashim
- Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - J Kral
- Institution for Clinical and Experimental Medicine, Prague, Czech Republic, Prague, Czechia
| | - K M Pawlak
- Hospital of the Ministry of Interior and Administration, Szczecin, Poland, Szczecin, Poland
| | - D S Sandhu
- Division of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, Cleveland, OH
| | - R N Lui
- Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China, Hong Kong, China
| | - S Sanchez-Luna
- Division of Gastroenterology and Hepatology, The University of New Mexico, Albuquerque, NM
| | - K Siau
- Institute of Translational Medicine, University Hospitals Birmingham, Birmingham, Birmingham, United Kingdom
| | - J Mosko
- St Michael’s Hospital, Toronto, ON, Canada
| | - S Grover
- St Michael’s Hospital, Toronto, ON, Canada
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