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Comparing procedures

One year results of LSG vs LGB vs ESG

Endoscopic sleeve gastroplasty achieved greater weight loss than laparoscopic banding, but less weight loss than laparoscopic sleeve gastrectomy surgery.

A study comparing laparoscopic banding, laparoscopic sleeve gastrectomy surgery and endoscopic sleeve gastroplasty, has reported that endoscopic sleeve gastroplasty achieved greater weight loss than laparoscopic banding, but less weight loss than laparoscopic sleeve gastrectomy surgery. Patients who received endoscopic sleeve gastroplasty had shorter hospital stays and lower costs than those who receive either laparoscopic procedures. The study was presented at Digestive Disease Week 2017.

Reem Z Sharaiha

"Obesity continues to be a problem in America and it is an epidemic rapidly spreading around the world," said Dr Reem Z Sharaiha, assistant professor of medicine at Weill Cornell Medicine and attending physician at New York-Presbyterian/Weill Cornell Medical Center, the study's lead author. "Our research, the first to compare these treatments, demonstrates that endoscopic sleeve gastroplasty is safe and effective in helping patients lead healthier lives. It should be considered as another tool available to clinicians and patients in the fight against obesity."

Sharaiha and colleagues followed 278 patients who underwent ESG (91 patients), laparoscopic sleeve gastrectomy (120 patients) or laparoscopic banding (67). During the one-year follow-up period, patients went to an academic bariatric Center of Excellence as part of their treatment.

At one-year follow-up, patients who chose laparoscopic sleeve gastrectomy surgery achieved the greatest percent total body weight loss at 29.28 percent, compared to 17.57 percent for endoscopic sleeve gastroplasty patients and 14.46 percent for laparoscopic banding patients. Researchers found that patients who received endoscopic treatment had lower complications (1 percent) than those who received surgical treatment (10 percent for laparoscopic sleeve gastrectomy and 11 percent for laparoscopic banding).

Sharaiha noted that these findings do not suggest that endoscopic sleeve gastroplasty will replace the two surgical treatments as weight-loss interventions. Instead, these results show that endoscopic sleeve gastroplasty is another possibility that patients and health-care providers should consider when discussing options.

The team also reported that endoscopic sleeve gastroplasty patients customarily left the hospital on the same day of treatment, while laparoscopic sleeve gastrectomy patients stayed for about three days and laparoscopic banding patients for a day and a half.

When examining cost, researchers reported endoscopic sleeve gastroplasty resulted in the lowest-cost, with an average institutional procedure cost of US$12,000, compared to US$22,000 for laparoscopic sleeve gastrectomy and US$15,000 for laparoscopic banding.

"For years, patients seeking weight-loss interventions had limited options because they could not tolerate or did not want surgery, or it was not even an option for them," she added. "Our research shows that endoscopic sleeve gastroplasty can be the treatment they've been looking for. It's less invasive than surgery and helps them reach their health goals."

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