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Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc. 2019 Apr;

Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc. 2019 Apr;

BACKGROUND AND AIMS:
Endoscopic sleeve gastroplasty (ESG) reduces the gastric lumen to a size comparable with that of
laparoscopic sleeve gastrectomy (LSG). However, there is a paucity of research comparing outcomes between the 2
procedures. Our study compared the 6-month weight loss outcomes and adverse events of ESG with LSG in a case-matched
cohort.


METHODS:
We retrospectively reviewed prospectively collected data for patients undergoing ESG or LSG at a single academic center.
Weight was recorded at 1 and 6 months postprocedure, and percent total body weight loss (%TBWL) was calculated. Adverse
events and new-onset Gastroesophageal Reflux Disease (GERD) were also recorded.
RESULTS:
A total of 54 ESG patients were matched with 83 LSG patients by age, sex, and body mass index. The proportion of patients
with GERD at baseline was similar in the 2 groups (16.7% in ESG group vs 25.3% in LSG group, P = .27). At the 6-month
follow-up, %TBWL (compared with baseline) was significantly lower in the ESG group compared with the LSG group (17.1% ±
6.5% vs 23.6% ± 7.6%, P < .01). ESG patients had significantly lower rates of adverse events compared with LSG patients
(5.2% vs 16.9%, P < .05). New-onset GERD was also significantly lower in the ESG group compared with the LSG group (1.9%
vs 14.5%, P < .05).
CONCLUSIONS:
ESG, a minimally invasive same-day procedure, achieved less weight loss at 6 months than LSG, with the caveat that LSG
caused more adverse events and new-onset GERD than ES