PDF herunterladen
CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(12): E1691-E1698
DOI: 10.1055/a-1007-1769
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Bariatric endoscopy procedure type or follow-up: What predicted success at 1 year in 962 obese patients?

Gontrand Lopez-Nava‡   *
1   Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Madrid, Spain.
,
Ravishankar Asokkumar‡   *
1   Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Madrid, Spain.
2   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
,
Angel Rull
1   Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Madrid, Spain.
,
Fernandez Corbelle
,
Lucia Beltran
1   Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Madrid, Spain.
,
Inmaculada Bautista
1   Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Madrid, Spain.
3   Ciber of Obesity and Nutrition Pathophysiology (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 31. Mai 2019

accepted after revision 16. August 2019

Publikationsdatum:
02. Dezember 2019 (online)

Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background and study aims It is uncertain if the difference in weight loss outcomes between different endoscopic bariatric therapies (EBTs) is technique-related or multidisciplinary team (MDT) follow-up-related. We hypothesized that at 1 year, the weight loss is determined more by adherence to MDT follow-up than by procedure type. We aimed to compare 1 year weight loss outcomes of four different EBTs at a single center with a standardized MDT follow-up.

Patients and methods We prospectively collected and retrospectively analyzed outcomes in 962 patients (female-691, 71.2 %; mean age, 44.8 ± 10.6 years, mean BMI, 37.8 ± 5.9 Kg/m2) treated with Intragastric balloons (IGBs) or endoscopic gastroplasty (EG) at HM Sanchinarro University Hospital between March 2012 to January 2017. The procedures were performed by the same endoscopist and followed up by the same MDT. We compared the percentage total body weight loss (%TWBL) at 1 year. We performed linear and logistic regression to identify predictive factors for weight loss and follow-up adherence at 1 year.

Results Four hundred and eighty-one IGBs (Orbera-80.9 %; ReShape Duo-19.1 %), and 481 EG (Apollo ESG-51.3 %; Primary obesity surgery endoluminal-POSE-48.6 %) were performed. Only 480 patients (IGB- 45 %; EG- 55 %) completed 1 year follow-up. Among them, Apollo ESG achieved significantly higher TBWL (19.5 ± 13 %, P = 0.035), %TBWL (17.4 ± 10.2 %, P = 0.025), and ≥ 20 % TBWL (36.7 %, P = 0.032). However, in linear regression after adjusting for variables, only higher initial BMI (B = 0.31, P < 0.001) and higher percentage follow-up attendance (B = 0.24, P < 0.001) significantly predicted %TBWL at 1 year in the completion group but not the procedure type (B = 0.02, P = 0.72). In logistic regression, we observed female sex (P = 0.01), high initial BMI (P < 0.001), endoscopic gastroplasty (P = 0.04), and high 1-month %TBWL (P < 0.001) significantly predicted follow-up completion at 1 year.

Conclusions Weight loss at 1 year is dependent on MDT follow-up rather than procedure type. Endoscopic gastroplasty promoted follow-up adherence more than IGBs.

* Drs. Lopez-Nava and Asokkumar: These authors contributed equally.


 

  • References

  • 1 Sullivan S, Kumar N. et al. ASGE Bariatric Endoscopy Task Force. ASGE position statement on endoscopic bariatric therapies in clinical practice. Gastrointest Endosc 2015; 82: 767-772
    CrossrefPubMedGoogle Scholar
  • 2 Abu Dayyeh BK, Edmundowicz S, Thompson CC. Clinical Practice Update: expert review on endoscopic bariatric therapies. Gastroenterology 2017; 152: 716-729
    CrossrefPubMedGoogle Scholar
  • 3 Abu Dayyeh BK. et al. ASGE Bariatric Endoscopy Task Force. Endoscopic bariatric therapies. Gastrointest Endosc 2015; 81: 1073-1086
    CrossrefPubMedGoogle Scholar
  • 4 Bazerbachi F, Vargas Valls EJ, Abu Dayyeh BK. Recent clinical results of endoscopic bariatric therapies as an obesity intervention. Clin Endosc 2017; 50: 42-50
    CrossrefPubMedGoogle Scholar
  • 5 Kumar N, Bazerbachi F, Rustagi T. et al. The influence of the Orbera intragastric balloon filling volumes on weight loss, tolerability, and adverse events: a systematic review and meta-analysis. Obes Surg 2017; 27: 2272-2278
    CrossrefPubMedGoogle Scholar
  • 6 Saber AA, Shoar S, Almadani MW. et al. Efficacy of first-time intragastric balloon in weight loss: a systematic review and meta-analysis of randomized controlled trials. Obes Surg 2017; 27: 277-287
    CrossrefPubMedGoogle Scholar
  • 7 Lopez-Nava G, Sharaiha RZ, Vargas EJ. et al. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-Up. Obes Surg 2017; 27: 2649-2655
    CrossrefPubMedGoogle Scholar
  • 8 López-Nava G, Bautista-Castaño I, Jimenez A. et al. The Primary Obesity Surgery Endolumenal (POSE) procedure: one-year patient weight loss and safety outcomes. Surg Obes Relat Dis 2015; 11: 861-865
    CrossrefPubMedGoogle Scholar
  • 9 Kumar N. Weight loss endoscopy: Development, applications, and current status. World J Gastroenterol 2016; 22: 7069-7079
    CrossrefPubMedGoogle Scholar
  • 10 Alqahtani A, Al-Darwish A, Mahmoud AE. et al. Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc 2019; 89: 1132-1138
    CrossrefPubMedGoogle Scholar
  • 11 Sharaiha RZ, Kumta NA, Saumoy M. et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol 2017; 15: 504-510
    CrossrefPubMedGoogle Scholar
  • 12 Abu Dayyeh BK, Kumar N. et al. ASGE Bariatric Endoscopy Task Force and ASGE Technology Committee. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc 2015; 82: 425-438
    CrossrefPubMedGoogle Scholar
  • 13 Al-Bawardy B, Mukewar SS, Genco A. et al. Mo1549 meta-analysis of the orbera intragastric balloon for the endoscopic management of obesity. Gastrointest Endosc 2015; 81: AB462
    PubMedGoogle Scholar
  • 14 Bazerbachi F, Haffar S, Sawas T. et al. Fluid-filled versus gas-filled intragastric balloons as obesity interventions: a network meta-analysis of randomized trials. Obes Surg 2018; 28: 2617-2625
    CrossrefPubMedGoogle Scholar
  • 15 Agnihotri A, Xie A, Bartalos C. et al. Real-world safety and efficacy of fluid-filled dual intragastric balloon for weight loss. Clin Gastroenterol Hepatol 2018; 16: 1081-1088.e1
    CrossrefPubMedGoogle Scholar
  • 16 Abu Dayyeh BK, Acosta A, Camilleri M. et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol 2017; 15: 37-43
    CrossrefPubMedGoogle Scholar
  • 17 Lopez-Nava G, Galvao M, Bautista-Castaño I. et al. Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success. Endosc Int Open 2016; 4: E222-E227
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 18 Lopez-Nava G, Rubio MA, Prados S. et al. BioEnterics® intragastric balloon (BIB®). Single ambulatory center Spanish experience with 714 consecutive patients treated with one or two consecutive balloons. Obes Surg 2011; 21: 5-9
    CrossrefPubMedGoogle Scholar
  • 19 Lopez-Nava G, Bautista-Castaño I, Jimenez-Baños A. et al. Dual intragastric balloon: single ambulatory center Spanish experience with 60 patients in endoscopic weight loss management. Obes Surg 2015; 25: 2263-2267
    CrossrefPubMedGoogle Scholar
  • 20 Khan Z, Khan MA, Hajifathalian K. et al. Efficacy of endoscopic interventions for the management of obesity: a meta-analysis to compare endoscopic sleeve gastroplasty, aspireassist, and primary obesity surgery. Endolumenal Obes Surg 2019; 29: 2287-2298
    PubMedGoogle Scholar
  • 21 Aranceta BartrinaJ, Arija ValV. et al. Grupo Colaborativo de la Sociedad Española de Nutrición Comunitaria (SENC). Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition. Nutr Hosp 2016; 33: 1-48
    PubMedGoogle Scholar
  • 22 Sharaiha RZ, Kedia P, Kumta N. et al. Initial experience with endoscopic sleeve gastroplasty: technical success and reproducibility in the bariatric population. Endoscopy 2015; 47: 164-166
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 23 Kumar N, Abu Dayyeh BK, Lopez-Nava BreviereG. et al. Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique. Surg Endosc 2018; 32: 2159-2164
    CrossrefPubMedGoogle Scholar
  • 24 Li P, Ma B, Gong S. et al. Efficacy and safety of endoscopic sleeve gastroplasty for obesity patients: a meta-analysis. Surg Endosc 2019; DOI: 10.1007/s00464-019-06889-6. [Epub ahead of print]
    CrossrefPubMedGoogle Scholar
  • 25 Fayad L, Adam A, Hill C. et al. Endoscopic sleeve gastroplasty versus intragastric balloons for the management of obesity. Gastrointest Endosc 2018; 87: AB609-AB610
    PubMedGoogle Scholar
  • 26 Sala M, Haller DL, Laferrère B. et al. Predictors of attrition before and after bariatric surgery. Obes Surg 2017; 27: 548-551
    CrossrefPubMedGoogle Scholar
  • 27 Bautista-Castaño I, Molina-Cabrillana J, Montoya-Alonso JA. et al. Variables predictive of adherence to diet and physical activity recommendations in the treatment of obesity and overweight, in a group of Spanish subjects. Int J Obes Relat Metab Disor 2004; 28: 697-705
    PubMedGoogle Scholar
  • 28 Wood GC, Benotti PN, Lee CJ. et al. Evaluation of the association between preoperative clinical factors and long-term weight loss after Roux-en-Y gastric bypass. JAMA Surg 2016; 151: 1056-1062
    CrossrefPubMedGoogle Scholar
  • 29 Pontiroli AE, Fossati A, Vedani P. et al. Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict the outcome of bariatric restrictive surgery in morbidly obese patients. Obes Surg 2007; 17: 1492-1497
    CrossrefPubMedGoogle Scholar
  • 30 Ortega E, Morínigo R, Flores L. et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc 2012; 26: 1744-1750
    CrossrefPubMedGoogle Scholar
  • 31 Goldenshluger A, Elazary R, Cohen MJ. et al. Predictors for adherence to multidisciplinary follow-up care after sleeve gastrectomy. Obes Surg 2018; 28: 3054-3061
    CrossrefPubMedGoogle Scholar
  • 32 Sillén L, Andersson E. Patient factors predicting weight loss after Roux-en-Y gastric bypass. J Obes 2017; 2017: 3278751
    PubMedGoogle Scholar
  • 33 Kaiser KA, Franks SF, Smith AB. Positive relationship between support group attendance and one-year post-operative weight loss in gastric banding patients. Surg Obesity Relat Dis 2011; 7: 89-93
    PubMedGoogle Scholar
  • 34 McVay MA, Friedman KE, Applegate KL. et al. Patient predictors of follow-up care attendance in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis 2013; 9: 956-962
    CrossrefPubMedGoogle Scholar
  • 35 Odom J, Zalesin KC, Washington TL. et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg 2010; 20: 349-356
    CrossrefPubMedGoogle Scholar