Four-year outcomes for endoscopic sleeve gastroplasty from a single centre in India

Mahak Bhandari; Susmit Kosta; Manoj Reddy; Winni Mathur; Manoel Galvao Neto; Mohit Bhandari

doi:10.4103/jmas.jmas_3_22

Four-year outcomes for endoscopic sleeve gastroplasty from a single centre in India

J Minim Access Surg. 2023 Jan-Mar;19(1):101-106. doi: 10.4103/jmas.jmas_3_22.

Authors

Mahak Bhandari¹, Susmit Kosta², Manoj Reddy¹, Winni Mathur³, Manoel Galvao Neto³, Mohit Bhandari³

Affiliations

¹ Department of Surgery, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
² Department of Central Research Lab, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.
³ Department of Surgery, Mohak Bariatrics and Robotics, Indore, Madhya Pradesh, India.

Abstract

Background: Bariatric endoscopy has emerged for non-surgical treatment of obesity, providing a treatment option for weight loss and associated comorbidities. Outcomes of endoscopic sleeve gastroplasty (ESG) of 12 months have been published by our team and there is a need for longer follow-up period understanding the effects of ESG techniques.

Aim: This report emphasises on weight loss pattern in follow-up time points and monitors the post-procedure improvement in comorbidities with minimum 4-year follow-up of patients undergoing ESG at a single academic centre in India.

Subjects and methods: This was a prospective cohort study. All procedures were performed by the same surgeon. Patients with a body mass index of >30 kg/m² (or >27 with comorbidities) underwent ESG for treatment of obesity. Patients were systematically followed yearly after their procedure. Data collected on the primary outcome and secondary outcomes were analysed and presented.

Results: 612 patients (69.3% female) with a mean age of 40.70 ± 12.66 years and mean body mass index of 34.30 ± 5.05 kg/m² underwent ESG. Out of 612 patients, follow-up rates for a 1-2-3 and 4 years were 93.1%, 90.2%, 81.7% and 81.9%, respectively. The mean percentage total body weight loss was 18.19% (95% confidence interval [CI]: 17.72-18.57) and %EWL was 49.30% (95% CI: 48.91-49.68) with 90% of participants-maintaining a percentage of total weight loss of ≥5% and 70% of patients maintaining an EWL of ≥25% at 4 years, respectively. Resolution/improvement of comorbidities was 51.2% cases of T2DM, 65.8% cases of hypertension, 73.6% cases of dyslipidaemia and 89.9% remission were in obstructive sleep apnoea. No patient required an emergency intervention, and there was no mortality or significant morbidity.

Conclusions: This study shows acceptable results with ESG at 4 years in our unit. Regular monitoring by a multidisciplinary nurtures weight loss, resolution or improvement of comorbidities and improvement of quality of life with low perioperative complications. There is a need for more reports with this approach to determine the amount and duration of weight loss outcome and medical intervention.

Keywords: Bariatrics; endoscopic sleeve gastroplasty; endoscopy; obesity; weight loss.