The POSE-2 Procedure for People with Obesity: A Safe and Effective Treatment Option.

PURPOSE: Besides lifestyle interventions, medication, and surgery, endoscopic options are becoming part of the current treatment landscape for people with obesity. With the POSE (Primary Obesity Surgery Endoscopic) procedure, endoluminal folds are created in the stomach with full-thickness sutures. Recently, the modified version, POSE-2, was introduced in clinical practice. This study aims to evaluate the safety and effectiveness of the POSE-2 procedure after one year in patients with obesity. MATERIALS AND METHODS: All patients treated with the POSE-2 procedure between March 2019 and November 2022 in the Zuyderland Medical Center and the Dutch Obesity Clinic were included in this retrospective data study. Inclusion criteria are as follows: age between 18 and 65 years and a BMI > 30 kg/m2. All patients with contraindications for the POSE-2 procedure were excluded. RESULTS: Forty-nine patients were included of which 86% were female, with a mean age of 46 years and mean BMI of 34.6 kg/m2. Total weight loss was evaluated at 3, 6, and 12 months and was 11.5%, 13.2%, and 14.8%, respectively. A median of 14 anchor sutures was used in a median procedure time of 50 min. All patients except one had same day discharge. Postprocedural complaints were mild and consisted of nausea and vomiting (36.7%) and pain (54.2%). No complications were recorded in this group. One week postprocedure, most patients (95.9%) reported feeling satisfied between meals. CONCLUSION: The POSE-2 procedure can be applied as a safe and effective treatment for people with obesity. This study presents a positive effect on weight reduction and no complications after 1 year of follow-up.

Disease Outcome of Ulcerative Colitis in an Era of Changing Treatment Strategies: Results from the Dutch Population-Based IBDSL Cohort.

BACKGROUND AND AIMS: In the past decades, treatment options and strategies for ulcerative colitis [UC] have radically changed. Whether these developments have altered the disease outcome at population level is yet unknown. Therefore, we evaluated the disease outcome of UC over the past two decades in the South-Limburg area of The Netherlands. METHODS: In the Dutch population-based IBDSL cohort, three time cohorts were defined: cohort 1991-1997 [cohort A], cohort 1998-2005 [cohort B], and cohort 2006-2010 [cohort C]. The colectomy and hospitalisation rates were compared between cohorts by Kaplan-Meier survival analyses. Hazard ratios [HR] for early colectomy [within 6 months after diagnosis], late colectomy [beyond 6 months after diagnosis], and hospitalisation were calculated using Cox regression models. RESULTS: In total, 476 UC patients were included in cohort A, 587 patients in cohort B, and 598 patients in cohort C. Over time, an increase in the use of immunomodulators [8.1%, 22.8% and 21.7%, respectively, p < 0.01] and biological agents [0%, 4.3% and 10.6%, respectively, p < 0.01] was observed. The early colectomy rate decreased from 1.5% in cohort A to 0.5% in cohort B [HR 0.14; 95% confidence interval 0.04-0.47], with no further decrease in cohort C [0.3%, HR 0.98; 95% confidence interval 0.20-4.85]. Late colectomy rate remained unchanged over time [4.0% vs 5.2% vs 3.6%, respectively, p = 0.54]. Hospitalisation rate was also similar among cohorts [22.3% vs 19.5% vs 18.3%, respectively, p = 0.10]. CONCLUSION: Over the past two decades, a reduction in early colectomy rate was observed, with no further reduction in the most recent era. Late colectomy rate and hospitalisation rate remained unchanged over time.