Prospective assessment of endoscopic sleeve gastroplasty for weight loss : is it in agreement with the recent-ESGE-ASGE guidelines ?

Aims Recent international guidelines (ASGE and ESGE) suggest an associated endoscopic treatment to lfe style management for the management of obesity class I and II. Reimbursement from national health insurance is linked to the availability of randomized controlled study or prospective study in this inndiscation. The aim of this prospective study was to assess the results of Endosleeve gastroplasty (ESG) associated to 18 months of lifestyle management (LSM).

Methods 29 patients (mean age 44 years) have been included in two centers experienced and dedicated to the management of obesity in this prospective study (NCT03900481). ESG was performed after 6 months of LSM and patients were followed for One year duration with continuous LSM. ESG was performed in all the cases with Endomina (Endotools, Brussels, Belgium). One night of hospital stay was scheduled. The mean weight at inclusion was 91.2 Kg (+ /-8.4) and the mean body mass index (BMI) was 33.98 (+ /-2.9) Kg/m², including 20 patients classI and 9 Class II.

Results 28 patients achieved a complete 12 months follow-up. Significant decrease of the total body weight loss (TBWL) was 10.2% ; p=P.001 (in 75% cases with TBWL decrease>5%). The final BMI was 30.5 Kg/m² with a significant decrease of the BMI p<0.001 resulting in 10.7% of patients with BMI<25 ; 32.1% patients with BMI ranging between 25 to 30 ; 57.1% of patients with BMI 30-35 and no more class II. The result Nadir was reached at 3 months for BMI and 6 months for weight loss. Quality of life score (sf12) was signifcantly improved (p=0.05). Only one adverse event occurred (sustained pain ; AGREE II)

Conclusions ESG associated with LSM results in significant TBWL and decrease of BMI and improvement of quality of life as suggested by International guidelines

Publication History

Article published online:
27 March 2025