Plus que de long discours, je vous propose de regarder les études existants sur le sujet.

Ce sont des études médicales, écrites en langue anglaise,  destinées à des médecins, mais vous pourrez voir objectivement que les résultats sont  homogènes : une perte de 17 à 22 % du poids corporel total obtenus entre un et deux ans, et maintenus dans le temps.

 
Abstract
Background and study aims: Emerging endoscopic techniques are minimally invasive and can mimic the anatomic alterations achieved by surgical sleeve gastrectomy. The objective of this study was to evaluate endoscopic sleeve gastroplasty.Patients and methods: This was a prospective, single-center study of 20 patients who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided postprocedure care. Patient status and weight were recorded at baseline, and at 1, 3, and 6 months after the procedure.Results: There were no adverse events and all patients were discharged in less than 24 hours. Baseline mean body mass index was 38.5 kg/m(2), and mean age was 45.8 years. Initial body weight (108.5 ± 14.9 kg) was significantly reduced. Following the procedure, the mean body weight reduction was 8.2 ± 2.5 kg at 1 month (% of initial weight loss 7.6 %; P < 0.05), 13.6 ± 4.8 kg at 3 months (12.4 % weight loss; P < 0.05), and 19.3 ± 8.9 kg at 6 months (17.8 % weight loss; P < 0.05).Conclusion: Endoscopic sleeve gastroplasty can be effective for the treatment of patients with obesity.
 
Abstract
Background: Endoscopic sleeve gastroplasty (ESG) has emerged as a promising technique in endoscopic bariatric and metabolic therapies (EBMTs). We aimed to perform a systematic review and meta-analysis to provide an update on its efficacy and safety.Methods: This is a systematic review and meta-analysis was performed following the PRISMA guidelines. MEDLINE, Cochrane, EMBASE, and LILACS were searched to identify the studies related to ESG.Results: Eleven studies with a total of 2170 patients were included. The average BMI pre-ESG was 35.78 kg/m2. Pooled mean %TWL observed at 6, 12, and 18 months was 15.3%, 16.1%, and 16.8% respectively. Pooled mean %EWL at 6, 12, and 18 months was 55.8%, 60%, and 73% respectively. No procedure-related mortality was reported.Conclusion: ESG is a safe and effective procedure for primary obesity therapy with promising short- and mid-term results.
Sérgio Barrichello 1Diogo Turiani Hourneaux de Moura 2Eduardo Guimaraes Hourneaux de Moura 3Pichamol Jirapinyo 4Anna Carolina Hoff 5Ricardo José Fittipaldi-Fernandez 5Giorgio Baretta 6João Henrique Felício Lima 6Eduardo N Usuy 1Leonardo Salles de Almeida 7Flavio M Ramos 8Felipe Matz 8Manoel Dos Passos Galvão Neto 9Christopher C Thompson 4
Abstract
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 ≤5% serious AE (SAE) rate following the American Society for Gastrointestinal Endoscopy (ASGE)/American Society for Metabolic and Bariatric Surgery (ASMBS) threshold.Results: A total of 193 patients underwent ESG during the study period. All groups had >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.
V.Costil
Abstract
Introduction et but de l’étude Les patients ayant une obésité non morbide ne peuvent pas bénéficier de la chirurgie bariatrique. La sleeve gastroplastie est une procédure d’aide à la perte de poids pour les patients obèses ayant un IMC < 35 ou une IMC < 40 sans comorbidités. Elle permet de réduire la taille de l’estomac en réalisant des sutures transmurales par endoscopie au niveau de la grande courbure de l’estomac du pylore à la jonction oesocardiale grâce à la technique de l’Overstitch, Matériel et méthodes Quarante patients ayant un IMC entre 30 et 40 ont bénéficié d’une sleeve endoscopique. Un bilan nutritionnel, comportemental et une évaluation de l’activité physique ainsi que la recherche de comorbidités liées à l’obésité ont été réalisés avant la procédure. L’évaluation de la NASH a été réalisée par une échographie abdominale avec calcul de l’indice de stéatose hépatique et recherche d’une fibrose hépatique. La durée de la procédure a été évaluée en fonction de la courbe d’apprentissage. Le suivi post-procédure a été réalisé par une équipe pluridisciplinaire (diététicienne comportementale, éducateur physique, psychologue) en présentiel avec l’équipe de l’établissement médical ou par visioconférence par MethodCO (www.methodco.fr). Résultats et analyse statistique La perte de poids moyenne est de 20 kg à 6 mois et le TEWL est supérieur à 15 % de 4 à 12 mois dans 91 % des cas. Il n’y a pas eu de complication. Des épigastralgies d’intensité modérée peuvent survenir dans les jours suivants la procédure. La durée de la procédure diminue avec la courbe d’apprentissage, en moyenne 80 mn après 18 patients. Le maintien et la poursuite de la perte de poids sont corrélés au suivi par l’équipe pluridisciplinaire, seul garant de la modification du comportement alimentaire et de la reprise d’une activité physique régulière. Conclusion La technique de réduction endoscopique de l’estomac par le système Overstich a montré son efficacité et sa tolérance pour perdre du poids et améliorer les comorbidités chez les patients en obésité non morbide qui ne peuvent pas bénéficier de chirurgie bariatrique. Son efficacité est corrélée au suivi pluridisciplinaire pour modifier le comportement alimentaire et reprendre une activité physique régulière.
Marincola
Abstract
Background and study aims Laparoscopic sleeve gastrectomy (LSG) is the current standard for bariatric surgery, but it is affected by several postoperative complications. Endoscopic sleeve gastroplasty (ESG) was created as a less invasive alternative to LSG. However, its efficacy and safety compared with LSG is unclear. Materials and methods Relevant publications were identified in MEDLINE/Cochrane/EMBASE/OVID/ PROSPERO and NIH up to January 2020. Studies were selected that included obese patients with a baseline body mass index (BMI) between 30 and 40 kg/m² with a minimum of 12 months of follow-up and with reported incidence of complications. The mean difference in percentage of excess weight loss (%EWL) at 12 months between LSG and ESG represented the primary endpoint. We also assessed the difference in pooled rate of adverse events. The quality of the studies and heterogeneity among them was analyzed. Results Sixteen studies were selected for a total of 2188 patients (LSG: 1429; ESG: 759) with a mean BMI 34.34 and 34.72 kg/m² for LSG and ESG, respectively. Mean %EWL was 80.32 % (± 12.20; 95 % CI; P = 0.001; I² = 98.88) and 62.20 % (± 4.38; 95 % CI; P = 0.005; I² = 65.52) for the LSG and ESG groups, respectively, corresponding to an absolute difference of 18.12 % (± 0.89; 95 % CI, P = 0.0001). The difference in terms of mean rate of adverse events was 0.19 % (± 0.37; 95 %CI; χ 2 = 1.602; P = 0.2056). Conclusions Our analysis showed a moderate superiority of LSG versus ESG. No difference in terms of safety was shown between the two groups. ESG is a less-invasive, repeatable and reversable and acceptable option for mild-moderate obese patients.
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