Suture pattern does not influence outcomes of endoscopic sleeve gastroplasty in obese patients

摘要

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.