Outcomes of Endoscopic Sleeve Gastroplasty Following Laparoscopic Adjustable Gastric Band: A Propensity Score-matched Analysis.

IF 1.1 4区医学 Q3 SURGERY Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-04-01 DOI:10.1097/SLE.0000000000001265

Daniel B Maselli, Chase Wooley, Daniel Lee, Areebah Waseem, Lauren L Donnangelo, Michelle Secic, Brian Coan, Christopher E McGowan

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Abstract

Background: The performance of endoscopic sleeve gastroplasty (ESG) in patients with prior laparoscopic adjustable gastric band (LAGB) has not been characterized.

Materials and methods: This is a retrospective propensity score-matched study of ESG after LAGB at 2 centers with expertise in bariatric endoscopy. The primary outcome was total weight loss (TWL) at 12 months. Secondary outcomes included TWL at 3 and 6 months, 12-month excess weight loss (EWL), procedural characteristics, predictors of TWL, and serious adverse events.

Results: Twenty-six adults (88.5% female, age 50.8 y, BMI 36.5 kg/m 2 ) with prior LAGB (median duration 8 y) underwent ESG at a median of 3 years after LAGB removal. A 2:1 age-matched, sex-matched, and BMI-matched comparator group was created, comprising ESG patients from the same organization and time frame but without prior LAGB. TWL for the LAGB-to-ESG cohort versus the ESG-only cohort was 10.1±5.5% versus 13.0±4.4% at 3 months ( P =0.0256), 12.4±7.2% versus 16.0±5.4% at 6 months ( P =0.0375), and 12.7±8.2% versus 18.4±6.5% at 12 months ( P =0.0149). At 12 months, the LAGB-to-ESG cohort had an EWL of 52.5±50.0%, and 75% achieved TWL ≥10%. There was no association between TWL at 3, 6, or 12 months and the following traits: age or BMI at the time of ESG, patient sex, and time from LAGB removal to ESG. No serious adverse events occurred in either cohort.

Conclusion: ESG after LAGB facilitates safe and clinically meaningful weight loss but is attenuated compared to primary ESG.

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腹腔镜可调节胃束带术后内镜袖带胃成形术的效果：倾向评分匹配分析

背景：内镜袖带胃成形术（ESG）在曾使用腹腔镜可调节胃束带（LAGB）的患者中的效果尚无定论：这是一项回顾性倾向评分匹配研究，在两家具有减肥内镜专长的中心对 LAGB 术后的 ESG 进行了研究。主要结果是 12 个月时的总体重减轻 (TWL)。次要结果包括 3 个月和 6 个月的总减重、12 个月的超重（EWL）、手术特点、总减重的预测因素以及严重不良事件：26 名曾接受过 LAGB（中位持续时间为 8 年）的成人（88.5% 为女性，年龄 50.8 岁，体重指数 36.5 kg/m2）在 LAGB 移除后 3 年接受了 ESG。此外，还设立了一个年龄、性别和 BMI 均为 2:1 的对比组，由来自相同机构和时间段但未接受过 LAGB 的 ESG 患者组成。3 个月时，LAGB 转 ESG 组的 TWL 为 10.1±5.5% 对 13.0±4.4% (P=0.0256)；6 个月时，TWL 为 12.4±7.2% 对 16.0±5.4% (P=0.0375)；12 个月时，TWL 为 12.7±8.2% 对 18.4±6.5% (P=0.0149)。12 个月时，LAGB-to-ESG 组群的 EWL 为 52.5±50.0%，75% 达到 TWL ≥10%。3、6、12 个月时的 TWL 与以下特征之间没有关联：ESG 时的年龄或体重指数、患者性别以及从 LAGB 移除到 ESG 的时间。两组患者均未发生严重不良事件：结论：LAGB 术后 ESG 有助于安全、有临床意义地减轻体重，但与原发性 ESG 相比，ESG 的作用有所减弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.