PMID- 31228432 OWN - NLM STAT- MEDLINE DCOM- 20200420 LR - 20200420 IS - 1097-6779 (Electronic) IS - 0016-5107 (Linking) VI - 90 IP - 5 DP - 2019 Nov TI - Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study. PG - 770-780 LID - S0016-5107(19)31958-3 [pii] LID - 10.1016/j.gie.2019.06.013 [doi] AB - BACKGROUND AND AIMS: Obesity is a pandemic affecting approximately 700 million adults worldwide, with an additional 2 billion overweight. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic bariatric therapy that involves remodeling of the greater curvature in an effort to reduce gastric capacity and delay gastric emptying. A variety of ESG suture patterns has been reported. This study is the first to use a uniform "U" stitch pattern across all centers to simplify technical aspects of the procedure and limit cost. This also uniquely assessed outcomes in all body mass index (BMI) categories and changes in metabolic rate, lean body mass, and adipose tissue composition. METHODS: This is a multicenter analysis of prospectively collected data from 7 centers including patients with overweight and obesity who underwent ESG. Primary outcomes included absolute weight loss, percent total body weight loss (%TWL), change in BMI, and percent excess weight loss (%EWL) at 6 and 12 months in overweight and obese classes I, II, and III. Secondary outcomes included adipose tissue, lean body mass reduction, and metabolic rate analyzed by bioimpedance. Additionally, immediate or delayed adverse events (AEs) were analyzed. Clinical success was defined as achieving >/=25% EWL at 1 year with 10% TWL and >25% EWL at 6 months of follow-up. On average, %TWL was 14.25% +/- 5.26% and 15.06% +/- 5.22% and the %EWL 56.15% +/- 22.93% and 59.41% +/- 25.69% at 6 months and 1 year of follow-up, respectively. %TWL was 8.91% +/- .3%, 13.92% +/- 5.76%, 16.22% +/- 7.69%, and 19.01% +/- .95% and %EWL 56.21% +/- 2.0%, 62.03% +/- 27.63%, 54.13% +/- 23.46%, and 46.78% +/- 2.43% for overweight and obesity classes I, II, and III, respectively, at 1 year. Male sex, age <41 years, and higher BMI were predictors of achieving a TWL >/=10% at 1-year follow-up. There was a significant reduction in adipose tissue from baseline. SAEs occurred in 1.03%, including 2 perigastric collections needing surgery. CONCLUSIONS: ESG appears to be feasible, safe, and effective in the treatment of patients with overweight and obesity according to ASGE/ASMBS thresholds. CI - Copyright (c) 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved. FAU - Barrichello, Sergio AU - Barrichello S AD - Healthme gerenciamento de perda de peso, Sao Paulo, Brazil. FAU - Hourneaux de Moura, Diogo Turiani AU - Hourneaux de Moura DT AD - Endoscopy Unit, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Hourneaux de Moura, Eduardo Guimaraes AU - Hourneaux de Moura EG AD - Endoscopy Unit, Department of Gastroenterology, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Jirapinyo, Pichamol AU - Jirapinyo P AD - Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Hoff, Anna Carolina AU - Hoff AC AD - Angioskope Clinic, Sao Jose dos Campos, Brazil. FAU - Fittipaldi-Fernandez, Ricardo Jose AU - Fittipaldi-Fernandez RJ AD - Angioskope Clinic, Sao Jose dos Campos, Brazil. FAU - Baretta, Giorgio AU - Baretta G AD - Endobatel Endoscopia Bariatrica Avancada, Curitiba, Brazil. FAU - Felicio Lima, Joao Henrique AU - Felicio Lima JH AD - Endobatel Endoscopia Bariatrica Avancada, Curitiba, Brazil. FAU - Usuy, Eduardo N AU - Usuy EN AD - Healthme gerenciamento de perda de peso, Sao Paulo, Brazil. FAU - de Almeida, Leonardo Salles AU - de Almeida LS AD - Instituto Mineiro de Obesidade (IMO), Belo Horizonte, Brazil. FAU - Ramos, Flavio M AU - Ramos FM AD - Endodiagnostic Clinic, Rio de Janeiro, Brazil. FAU - Matz, Felipe AU - Matz F AD - Endodiagnostic Clinic, Rio de Janeiro, Brazil. FAU - Galvao Neto, Manoel Dos Passos AU - Galvao Neto MDP AD - Department of Surgery, Florida International University, Miami, Florida, USA. FAU - Thompson, Christopher C AU - Thompson CC AD - Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20190619 PL - United States TA - Gastrointest Endosc JT - Gastrointestinal endoscopy JID - 0010505 SB - IM CIN - Gastrointest Endosc. 2019 Nov;90(5):781-783. PMID: 31635715 MH - Adiposity MH - Adult MH - Age Factors MH - Basal Metabolism MH - Body Mass Index MH - Brazil MH - Endoscopy, Gastrointestinal MH - Female MH - Gastroplasty/adverse effects/*methods MH - Humans MH - Male MH - Middle Aged MH - Obesity/physiopathology/*surgery MH - Retrospective Studies MH - Sex Factors MH - *Suture Techniques/adverse effects MH - United States MH - Weight Loss EDAT- 2019/06/23 06:00 MHDA- 2020/04/21 06:00 CRDT- 2019/06/23 06:00 PHST- 2019/03/08 00:00 [received] PHST- 2019/06/07 00:00 [accepted] PHST- 2019/06/23 06:00 [pubmed] PHST- 2020/04/21 06:00 [medline] PHST- 2019/06/23 06:00 [entrez] AID - S0016-5107(19)31958-3 [pii] AID - 10.1016/j.gie.2019.06.013 [doi] PST - ppublish SO - Gastrointest Endosc. 2019 Nov;90(5):770-780. doi: 10.1016/j.gie.2019.06.013. Epub 2019 Jun 19.