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Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study

BACKGROUND: Bariatric weight-loss surgery rates are increasing internationally. Endoscopic sleeve gastroplasty (ESG) is a novel, minimally invasive endoscopic procedure thought to mimic some of the effects of a more common surgery, laparoscopic sleeve gastrectomy (LSG). Patient factors affecting pro...

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Autores principales: Marshall, Skye, G Rich, Graeme, Cohen, Felicity, Soni, Asha, Isenring, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732757/
https://www.ncbi.nlm.nih.gov/pubmed/36422944
http://dx.doi.org/10.2196/29713
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author Marshall, Skye
G Rich, Graeme
Cohen, Felicity
Soni, Asha
Isenring, Elizabeth
author_facet Marshall, Skye
G Rich, Graeme
Cohen, Felicity
Soni, Asha
Isenring, Elizabeth
author_sort Marshall, Skye
collection PubMed
description BACKGROUND: Bariatric weight-loss surgery rates are increasing internationally. Endoscopic sleeve gastroplasty (ESG) is a novel, minimally invasive endoscopic procedure thought to mimic some of the effects of a more common surgery, laparoscopic sleeve gastrectomy (LSG). Patient factors affecting procedural choice are unexplored. OBJECTIVE: This formative study aimed to determine the preoperative and early postoperative characteristics of adults matched for age, sex, and BMI who chose ESG versus LSG. METHODS: This prospective cohort study recruited ESG and matched LSG adults in Australia. Preoperative outcomes were medical history, glycemic biomarkers, blood lipids, liver function enzymes, albumin, blood pressure, hepatic steatosis index, the Gastrointestinal Symptom Rating Scale, the Impact of Weight on Quality of Life–Lite questionnaire, and body composition via dual-energy x-ray absorptiometry. Adverse events were recorded preoperatively and up to 2 weeks postoperatively. SPSS was used to test if there were differences between cohorts by comparing means or mean ranks, and binary regression was used to understand how characteristics might predict procedure choice. RESULTS: A total of 50 (including 25 ESG and 25 LSG) patients were recruited, who were primarily White (45/50, 90%) and female (41/50, 82%) with a mean age of 41.7 (SD 9.4) years. Participants had a mean of 4.0 (SD 2.2) active comorbid conditions, with the most common being nonalcoholic fatty liver disease (38/50, 76%), back pain (32/50, 64%), anxiety or depression (24/50, 48%), and joint pain (23/50, 46%). The LSG cohort had higher hemoglobin A(1c) (5.3%, SD 0.2%) than the ESG cohort (5%, SD 0.2%; P=.008). There was a 2.4 kg/m(2) difference in median BMI (P=.03) between the groups, but fat and fat-free mass had no meaningful differences. Comparing the LSG and ESG groups showed that the LSG group had lower total quality of life (49.5%, SD 10.6% vs 56.6%, SD 12.7%; P=.045), lower weight-related self-esteem (10.7%, IQR 3.6%-25% vs 25%, IQR 17.9%-39.3%; P=.02), and worse abdominal pain (38.9%, IQR 33.3%-50% vs 53.9%, SD 14.2%, P=.01). For every percent improvement in weight-related self-esteem, the odds for selecting ESG increased by 4.4% (95% CI 1.004-1.085; P=.03). For every percent worsening in hunger pain, the odds for selecting ESG decreased by 3.3% (95% CI 0.944-0.990; P=.004). CONCLUSIONS: There was very little evidence that Australian adults who chose an endoscopic versus surgical sleeve had different rates of comorbidities, body fat percentage, or weight-related quality of life. There was evidence against the test hypothesis, that is, there was evidence suggesting that lower self-esteem predicted choosing a more invasive sleeve (ie, LSG rather than ESG) TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry ACTRN12618000337279; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374595
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spelling pubmed-97327572022-12-10 Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study Marshall, Skye G Rich, Graeme Cohen, Felicity Soni, Asha Isenring, Elizabeth JMIR Form Res Original Paper BACKGROUND: Bariatric weight-loss surgery rates are increasing internationally. Endoscopic sleeve gastroplasty (ESG) is a novel, minimally invasive endoscopic procedure thought to mimic some of the effects of a more common surgery, laparoscopic sleeve gastrectomy (LSG). Patient factors affecting procedural choice are unexplored. OBJECTIVE: This formative study aimed to determine the preoperative and early postoperative characteristics of adults matched for age, sex, and BMI who chose ESG versus LSG. METHODS: This prospective cohort study recruited ESG and matched LSG adults in Australia. Preoperative outcomes were medical history, glycemic biomarkers, blood lipids, liver function enzymes, albumin, blood pressure, hepatic steatosis index, the Gastrointestinal Symptom Rating Scale, the Impact of Weight on Quality of Life–Lite questionnaire, and body composition via dual-energy x-ray absorptiometry. Adverse events were recorded preoperatively and up to 2 weeks postoperatively. SPSS was used to test if there were differences between cohorts by comparing means or mean ranks, and binary regression was used to understand how characteristics might predict procedure choice. RESULTS: A total of 50 (including 25 ESG and 25 LSG) patients were recruited, who were primarily White (45/50, 90%) and female (41/50, 82%) with a mean age of 41.7 (SD 9.4) years. Participants had a mean of 4.0 (SD 2.2) active comorbid conditions, with the most common being nonalcoholic fatty liver disease (38/50, 76%), back pain (32/50, 64%), anxiety or depression (24/50, 48%), and joint pain (23/50, 46%). The LSG cohort had higher hemoglobin A(1c) (5.3%, SD 0.2%) than the ESG cohort (5%, SD 0.2%; P=.008). There was a 2.4 kg/m(2) difference in median BMI (P=.03) between the groups, but fat and fat-free mass had no meaningful differences. Comparing the LSG and ESG groups showed that the LSG group had lower total quality of life (49.5%, SD 10.6% vs 56.6%, SD 12.7%; P=.045), lower weight-related self-esteem (10.7%, IQR 3.6%-25% vs 25%, IQR 17.9%-39.3%; P=.02), and worse abdominal pain (38.9%, IQR 33.3%-50% vs 53.9%, SD 14.2%, P=.01). For every percent improvement in weight-related self-esteem, the odds for selecting ESG increased by 4.4% (95% CI 1.004-1.085; P=.03). For every percent worsening in hunger pain, the odds for selecting ESG decreased by 3.3% (95% CI 0.944-0.990; P=.004). CONCLUSIONS: There was very little evidence that Australian adults who chose an endoscopic versus surgical sleeve had different rates of comorbidities, body fat percentage, or weight-related quality of life. There was evidence against the test hypothesis, that is, there was evidence suggesting that lower self-esteem predicted choosing a more invasive sleeve (ie, LSG rather than ESG) TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry ACTRN12618000337279; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374595 JMIR Publications 2022-11-24 /pmc/articles/PMC9732757/ /pubmed/36422944 http://dx.doi.org/10.2196/29713 Text en ©Skye Marshall, Graeme G Rich, Felicity Cohen, Asha Soni, Elizabeth Isenring. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.11.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Marshall, Skye
G Rich, Graeme
Cohen, Felicity
Soni, Asha
Isenring, Elizabeth
Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
title Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
title_full Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
title_fullStr Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
title_full_unstemmed Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
title_short Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
title_sort matched endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy cases: formative cohort study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732757/
https://www.ncbi.nlm.nih.gov/pubmed/36422944
http://dx.doi.org/10.2196/29713
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