de Moura DTH, Barrichello S Jr, de Moura EGH, de Souza TF, Dos Passos Galvão Neto M, Grecco E, Sander B, Hoff AC, Matz F, Ramos F, de Lima JHF, Teixeira L, Dib V, Falcão M, Potti H, Baretta G, Jirapinyo P, and Thompson CC
Background: Sleeve gastrectomy is a well-standardized surgical treatment for obesity. However, rates of weight regain after sleeve gastrectomy in long-term follow-up are relatively high. This multicenter study is the first to evaluate the use of an endoscopic sleeve gastroplasty (ESG) technique for the management of this population., Methods: This was a multicenter retrospective study, including patients with weight regain following sleeve gastrectomy who underwent ESG for weight loss. Primary outcomes included absolute weight loss, percent total weight loss (%TWL), change in body mass index (BMI), percent excess weight loss (%EWL) at 6 and 12 months, and safety profile. Clinical success was defined as achieving ≥ 25 % EWL at 1 year, ≤ 5 % serious adverse event (SAE) rate following society-recommended thresholds, and %TWL ≥ 10 %., Results: 34 patients underwent ESG after sleeve gastrectomy. Technical success was 100 %. At 1 year, 82.4 % and 100 % of patients achieved ≥ 10 %TWL and ≥ 25 % EWL, respectively. Mean (SD) %TWL was 13.2 % (3.9) and 18.3 % (5.5), and %EWL was 51.9 % (19.1) and 69.9 % (29.9) at 6 months and 1 year, respectively. Mean (SD) %TWL was 14.2 % (12.5), 19.3 % (5.3), 17.5 % (5.2), and 20.4 % (3.3), and %EWL was 88.5 % (52.8), 84.4 % (22.4), 55.4 % (14.8), and 47.8 % (11.2) for BMI categories of overweight and obesity class I, II, and III, respectively, at 1 year. No predictors of success were identified in the multivariable regression analysis. No SAEs were reported., Conclusion: ESG appears to be safe and effective in the management of weight regain following sleeve gastrectomy., Competing Interests: Dr. E. G. H. de Moura is a consultant (with nonfinancial support) for Boston Scientific and Olympus. Dr. Galvão Neto has received grants and personal fees from Fractyl Labs, GI dynamics, GI windows, Apollo Endosurgery, Olympus, Medtronic, and M.I. Tech. Dr. Thompson has received grants from Apollo Endosurgery and Olympus, and personal fees from Medtronic, Boston Scientific, Apollo Endosurgery, and Olympus., (© Georg Thieme Verlag KG Stuttgart · New York.)