Stephanie Joseph, Vanessa N. Vandruff, Julia R. Amundson, Simon Che, Christopher Zimmermann, Shun Ishii, Kristine Kuchta, H. Mason Hedberg, Woody Denham, John Linn, Michael B. Ujiki
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Pre- and post-surgical data were compared using chi-square and two-sample <i>t</i> tests. Improvement or resolution of obesity-related comorbidities were also assessed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 212 LSG and 68 ESG patients were reviewed. ESG patients were older (47 ± 10 vs. 43 ± 12, <i>p</i> = 0.006) and less obese (BMI 37.0 ± 5.5 vs. 45.8 ± 0.4, <i>p</i> < 0.001) than LSG patients. Median length of stay after ESG was 0 days and after LSG 1 day (<i>p</i> < 0.001). Severe adverse events were seen less frequent after ESG (1.47%, vs 3.77%). LSG achieved more significant %TBWL at 6 months (25.2 ± 8.9 vs 14.9 ± 7.4), 1 year (27.5 ± 10.8 vs 14.1 ± 9.8), and 2 years (25.7 ± 10.8 vs 10.5 ± 8.8, all <i>p</i> < 0.001) after surgery when compared to ESG. LSG achieved significantly greater %EWL compared to ESG at 6 months (57.0 ± 20.7 vs 50.4 ± 29.2, <i>p</i> = 0.137), 1 year (61.4 ± 24.6 vs 46.5 ± 34.0, <i>p</i> = 0.026), and 2 years postoperatively (59.7 ± 25.5 vs 32.6 ± 28.2, <i>p</i> = 0.001). There were no statistically significant differences in rates of improvement or resolution of diabetes, obstructive sleep apnea, hyperlipidemia, or hypertension.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>ESG is an effective procedure for weight loss and comorbidity resolution. Obesity-related comorbidities are comparably improved and resolved following ESG vs LSG. Although the weight loss in LSG is significantly higher, patients can expect a shorter hospital length of stay and a lower rate of complications after ESG. 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Median length of stay after ESG was 0 days and after LSG 1 day (<i>p</i> < 0.001). Severe adverse events were seen less frequent after ESG (1.47%, vs 3.77%). LSG achieved more significant %TBWL at 6 months (25.2 ± 8.9 vs 14.9 ± 7.4), 1 year (27.5 ± 10.8 vs 14.1 ± 9.8), and 2 years (25.7 ± 10.8 vs 10.5 ± 8.8, all <i>p</i> < 0.001) after surgery when compared to ESG. LSG achieved significantly greater %EWL compared to ESG at 6 months (57.0 ± 20.7 vs 50.4 ± 29.2, <i>p</i> = 0.137), 1 year (61.4 ± 24.6 vs 46.5 ± 34.0, <i>p</i> = 0.026), and 2 years postoperatively (59.7 ± 25.5 vs 32.6 ± 28.2, <i>p</i> = 0.001). There were no statistically significant differences in rates of improvement or resolution of diabetes, obstructive sleep apnea, hyperlipidemia, or hypertension.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>ESG is an effective procedure for weight loss and comorbidity resolution. 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引用次数: 0
摘要
背景尽管手术效果极佳，但只有少数符合条件的患者接受了减肥手术。内镜袖状胃成形术（ESG）是一种无切口手术，已被证明能有效减轻体重并改善合并症。我们旨在比较 ESG 与腹腔镜袖状胃切除术（LSG）的疗效。方法对 2016 年至 2023 年期间在 NorthShore University HealthSystem 接受 ESG 和 LSG 手术的患者的前瞻性数据库进行了回顾性审查。分析了人口统计学和结果数据。使用卡方检验和双样本 t 检验比较了手术前和手术后的数据。此外，还评估了肥胖相关合并症的改善或缓解情况。与 LSG 患者相比，ESG 患者年龄更大（47 ± 10 vs. 43 ± 12，p = 0.006），肥胖程度更轻（BMI 37.0 ± 5.5 vs. 45.8 ± 0.4，p < 0.001）。ESG 术后的中位住院时间为 0 天，LSG 术后为 1 天（p < 0.001）。ESG 后发生严重不良事件的比例较低（1.47% vs 3.77%）。与 ESG 相比，LSG 在术后 6 个月（25.2±8.9 vs 14.9±7.4）、1 年（27.5±10.8 vs 14.1±9.8）和 2 年（25.7±10.8 vs 10.5±8.8，均 p <0.001）的髋关节屈曲度（TBWL）显著增加。与 ESG 相比，LSG 在术后 6 个月（57.0 ± 20.7 vs 50.4 ± 29.2，p = 0.137）、1 年（61.4 ± 24.6 vs 46.5 ± 34.0，p = 0.026）和 2 年（59.7 ± 25.5 vs 32.6 ± 28.2，p = 0.001）所获得的 EWL 百分比明显更高。在糖尿病、阻塞性睡眠呼吸暂停、高脂血症或高血压的改善或缓解率方面，差异无统计学意义。ESG与LSG相比，肥胖相关合并症的改善和缓解程度相当。虽然 LSG 的减重效果明显更高，但 ESG 术后患者的住院时间更短，并发症发生率更低。ESG 继续显示出长期减轻体重和改善健康的前景。
Comparable improvement and resolution of obesity-related comorbidities in endoscopic sleeve gastroplasty vs laparoscopic sleeve gastrectomy: single-center study
Background
Despite excellent surgical outcomes, a minority of qualified patients undergo weight loss surgery. Endoscopic Sleeve Gastroplasty (ESG), an incisionless procedure, has proven to be effective in achieving weight loss and comorbidity improvement. We aim to compare outcomes of ESG to those of Laparoscopic Sleeve Gastrectomy (LSG).
Method
A retrospective review of a prospective database of patients who underwent ESG and LSG at NorthShore University HealthSystem from 2016 to 2023 was completed. Demographic and outcome data were analyzed. Pre- and post-surgical data were compared using chi-square and two-sample t tests. Improvement or resolution of obesity-related comorbidities were also assessed.
Results
A total of 212 LSG and 68 ESG patients were reviewed. ESG patients were older (47 ± 10 vs. 43 ± 12, p = 0.006) and less obese (BMI 37.0 ± 5.5 vs. 45.8 ± 0.4, p < 0.001) than LSG patients. Median length of stay after ESG was 0 days and after LSG 1 day (p < 0.001). Severe adverse events were seen less frequent after ESG (1.47%, vs 3.77%). LSG achieved more significant %TBWL at 6 months (25.2 ± 8.9 vs 14.9 ± 7.4), 1 year (27.5 ± 10.8 vs 14.1 ± 9.8), and 2 years (25.7 ± 10.8 vs 10.5 ± 8.8, all p < 0.001) after surgery when compared to ESG. LSG achieved significantly greater %EWL compared to ESG at 6 months (57.0 ± 20.7 vs 50.4 ± 29.2, p = 0.137), 1 year (61.4 ± 24.6 vs 46.5 ± 34.0, p = 0.026), and 2 years postoperatively (59.7 ± 25.5 vs 32.6 ± 28.2, p = 0.001). There were no statistically significant differences in rates of improvement or resolution of diabetes, obstructive sleep apnea, hyperlipidemia, or hypertension.
Conclusion
ESG is an effective procedure for weight loss and comorbidity resolution. Obesity-related comorbidities are comparably improved and resolved following ESG vs LSG. Although the weight loss in LSG is significantly higher, patients can expect a shorter hospital length of stay and a lower rate of complications after ESG. ESG continues to show promise for long-term weight loss and improvement in health.
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