Endoscopic sleeve gastroplasty: Prospective assessment of weight loss and metabolic impact

Recent international guidelines (American Society for Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy) suggest endoscopic treatment plus lifestyle management for management of obesity class I and II. The aim of this prospective study was to assess results of Endosleeve gastroplasty (ESG) plus lifestyle management (LSM).

Twenty-nine patients (mean age 44 years) were included in a longitudinal prospective cohort study in two experienced centers. Mean weight at inclusion was 91.13 kg (± 8.4) and mean body mass index (BMI) was 34.08 (± 2.43) kg/m ² . ESG was performed using Endomina (Endo Tools Therapeutics S.A., Gosselies, Belgium) 6 months after LSM and patients were followed for 1 year with continuous LSM.

Twenty-eight patients completed 12-month follow-up. Total body weight loss (TBWL) was 11.05% ( P < 0.001, 81.2% of cases with TBWL decrease > 5 %). EWL was significantly reached in 40.98% ( P < 0.001). Final BMI was significantly decreased (30.52 kg/m ² ; P < 0.001). Glucose control and HbA1c level were significantly improved at 1 year ( P = 0.01 and P = 0.003). Liver function tests (gamma-glutamyl transferase, alanine aminotransferase) were significantly decreased ( P = 0.006 and P = 0.009). Diastolic arterial pressure significantly decreased at 1 year ( P < 0.001). Quality of life (QoL) score (sf12) for physical activity was significantly improved ( P = 0.05). Only one adverse event was noted (sustained pain; AGREE II). No nutritional deficiency assessed by biological measurements appeared during follow-up.

ESG combined with LSM resulted in significant improvement in TBWL, EWL, BMI, and QoL. Metabolic improvements were also observed without leading to nutritional deficiency.