Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support.
BMC Prim Care
; 23(1): 26, 2022 02 05.
Article
em En
| MEDLINE
| ID: mdl-35123409
ABSTRACT
BACKGROUND:
The laparoscopic sleeve gastrectomy (LSG) and the incisionless endoscopic sleeve gastroplasty (ESG) weight loss procedures require further investigation of their efficacy, safety and patient-centered outcomes in the Australian setting.METHODS:
The aim was to examine the 6- and 12-month weight loss efficacy, safety, and weight-related quality of life (QoL) of adults with obesity who received the ESG or LSG bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postprocedural support. Data were from a two-arm prospective cohort study that followed patients from baseline to 12-months postprocedure from a medical center in Queensland. Percent excess weight loss (%EWL) was the primary outcome. Secondary outcomes were body composition (fat mass, fat-free mass, androidgynoid ratio, bone mineral content) via dual energy X-ray absorptiometry, weight-related QoL, lipid, glycemic, and hepatic biochemistry, and adverse events.RESULTS:
16 ESG (19% attrition; 81.2% female; aged41.4 (SD 10.4) years; BMI 35.5 (SD 5.2) kg/m2) and 45 LSG (9% attrition; 84.4% female; aged40.4 (SD 9.0) years; BMI 40.7 (SD 5.6) kg/m2) participants were recruited. At 12-months postprocedure, ESG %EWL was 57% (SD 32%; p < 0.01) and LSG %EWL was 79% (SD 24%; p < 0.001). ESG and LSG cohorts improved QoL (19.8% in ESG [p > 0.05]; 48.1% in LSG [p < 0.05]), liver function (AST - 4.4 U/L in ESG [p < 0.05]; - 2.7 U/L in LSG [p < 0.05]), HbA1c (- 0.5% in ESG [p < 0.05]; - 0.1% in LSG [p < 0.05]) and triglycerides (- 0.6 mmol/L in ESG [p > 0.05]; - 0.4 mmol/L in LSG [P < 0.05]) at 12-months. Both cohorts reduced fat mass (p < 0.05). The ESG maintained but LSG decreased fat-free mass at 6-months (p < 0.05); and both cohorts lost fat-free mass at 12-months (p < 0.05). There were no adverse events directly related to the procedure. The ESG reported 25% mild-moderate adverse events possibly related to the procedure, and the LSG reported 27% mild-severe adverse events possibly related to the procedure.CONCLUSIONS:
In this setting, the ESG and LSG were safe and effective weight loss treatments for obese adults alongside multidisciplinary support. Patients who elected the ESG maintained fat-free mass at 6-months but both cohorts lost fat-free mass at 12-months postprocedure. Patients who elected the LSG had large and significant improvements to weight-related quality of life. Further well-powered studies are required to confirm these findings. TRIAL REGISTRATION This study was registered prospectively at the Australia New Zealand Clinical Trials Registry on 06/03/2018, Registration Number ACTRN12618000337279 .Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Gastroplastia
/
Laparoscopia
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article