TY - JOUR AU - Farha, Jad; McGowan, Christopher; Hedjoudje, Abdellah; Itani, Mohamad I.; Abbarh, Shahem; Simsek, Cem; Ichkhanian, Yervant; Vulpis, Trish; James, Theodore W.; Fayad, Lea; Khashab, Mouen A.; Oberbach, Andreas; Badurdeen, Dilhana; Kumbhari, Vivek TI - Endoscopic sleeve gastroplasty: suturing the gastric fundus does not confer benefit SN - 0013-726X SN - 1438-8812 PY - 2020 JO - Endoscopy JF - Endoscopy LA - EN VL - 53 IS - 07 SP - 727 EP - 731 DA - 2020/10/08 ET - 2020/08/10 AB - Background There is heterogeneity regarding the technical aspects of endoscopic sleeve gastroplasty (ESG), such as applying fundal sutures. Our aim was to determine whether ESG with fundal suturing (ESG-FS) affects weight loss and the serious adverse event (SAE) rate when compared with ESG with no fundal suturing (ESG-NFS).Methods We conducted a two-center retrospective analysis of 247 patients who underwent ESG with or without fundal suturing. The primary outcome was percentage excess weight loss (%EWL) at 3, 6, and 12 months post-ESG. The secondary outcomes included the SAE rate and procedure duration.Results At 3, 6, and 12-months, ESG-NFS had a significantly greater mean %EWL compared with ESG-FS (38.4 % [standard deviation (SD) 15.3 %] vs. 31.2 % [SD 13.9 %], P = 0.001; 54.7 % [SD 19.2 %] vs. 37.7 % [SD 17.3 %], P < 0.001; 65.3 % [SD 21.1 %] vs. 40.6 % [SD 23.5 %], P < 0.001, respectively). There was no statistically significant difference in the SAE rates for ESG-NFS (n = 2; 2.0 %) and ESG-FS (n = 4; 2.6 %; P > 0.99). The mean procedure time was significantly shorter in the ESG-NFS group at 59.1 minutes (SD 32.7) vs. 93.0 minutes (35.5; P < 0.001), and a lower mean number of sutures were used, with 5.7 (SD 1.1) vs. 8.4 (SD 1.6; P < 0.001).Conclusion ESG-NFS demonstrated greater efficacy and shorter procedure duration. Therefore, fundal suturing should not be performed. PB - Georg Thieme Verlag KG DO - 10.1055/a-1236-9347 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1236-9347 ER -