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The Efficacy and Safety of Endoscopic Sleeve Gastroplasty as an Alternative to Laparoscopic Sleeve Gastrectomy

The Study Group for Endoscopic Bariatric and Metabolic Therapies of the Korean Society of Gastrointe|Jin Young Yoon|Román Turró Arau
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2021.01|Clinical Endoscopy|제54권 제1호|pp. 17-24|DOI 10.5946/ce.2021.019

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키워드

EfficacySafetyObesityEndoscopic sleeve gastroplastyLaparoscopic sleeve gastroplasty
주제분류내과학

초록

Endoscopic sleeve gastroplasty (ESG) is a therapeutic endoscopic technique for reducing the size of the gastric reservoir in obesepatients, using a full-thickness endoscopic suturing device. The effectiveness of ESG in weight loss is significantly greater than that ofhigh-intensity diet and lifestyle therapy and lower than that of laparoscopic sleeve gastrectomy (LSG). The efficacy at 12 months afterESG in terms of percentage of total body weight loss and excess body weight loss was approximately 16% and 60%, respectively. Thewell-known predictive factors for increased weight loss by ESG are good compliance with regular monitoring and post-procedurecare involving a multidisciplinary team approach. Although the underlying mechanism of weight loss induced by ESG is debatable,delayed gastric emptying and early satiation are some of the proposed mechanisms. The pooled rate of adverse events after ESGreported in several meta-analysis studies ranged from 1.5% to 2.3% and the incidence of new-onset gastroesophageal reflux diseaseafter ESG was negligible, indicating that ESG has a superior safety profile to LSG. Moreover, ESG reduced the risk of obesity-relatedmetabolic comorbidities, evidenced by the reduction in HbA1c level, systolic blood pressure, triglyceride level, and risk of hepaticsteatosis and fibrosis; it even improved the quality of life. ESG could be considered safe and qualify as an alternative treatment toLSG.

Abstract

Endoscopic sleeve gastroplasty (ESG) is a therapeutic endoscopic technique for reducing the size of the gastric reservoir in obesepatients, using a full-thickness endoscopic suturing device. The effectiveness of ESG in weight loss is significantly greater than that ofhigh-intensity diet and lifestyle therapy and lower than that of laparoscopic sleeve gastrectomy (LSG). The efficacy at 12 months afterESG in terms of percentage of total body weight loss and excess body weight loss was approximately 16% and 60%, respectively. Thewell-known predictive factors for increased weight loss by ESG are good compliance with regular monitoring and post-procedurecare involving a multidisciplinary team approach. Although the underlying mechanism of weight loss induced by ESG is debatable,delayed gastric emptying and early satiation are some of the proposed mechanisms. The pooled rate of adverse events after ESGreported in several meta-analysis studies ranged from 1.5% to 2.3% and the incidence of new-onset gastroesophageal reflux diseaseafter ESG was negligible, indicating that ESG has a superior safety profile to LSG. Moreover, ESG reduced the risk of obesity-relatedmetabolic comorbidities, evidenced by the reduction in HbA1c level, systolic blood pressure, triglyceride level, and risk of hepaticsteatosis and fibrosis; it even improved the quality of life. ESG could be considered safe and qualify as an alternative treatment toLSG.

참고문헌 (55)

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