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

Background and study aims: 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). Patients and methods: 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/m². 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. Results: 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/m²; 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. Conclusions: ESG combined with LSM resulted in significant improvement in TBWL, EWL, BMI, and QoL. Metabolic improvements were also observed without leading to nutritional deficiency.