Endoscopic assessment of morphological and histopathological upper gastrointestinal changes after endoscopic sleeve gastroplasty

Margherita Pizzicannella, Claudio Fiorillo, Manuel Barberio, María Rita Rodríguez-Luna, Michel Vix, Didier Mutter, Jacques Marescaux, Guido Costamagna, Lee Swanström, Silvana Perretta

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background: Endoscopic sleeve gastroplasty (ESG) is a promising bariatric endoluminal procedure. Restriction and shortening of the stomach are obtained by means of non-resorbable full-thickness sutures, thus inducing the formation of several endoluminal pouches in which food can stagnate. The effect of ESG on the upper gastrointestinal tract has never been investigated.Objectives: This study objectively evaluates endoscopic macroscopic and histopathologic changes within 12-month follow-up (FU) in patients who underwent ESG.Setting: Retrospective study on a prospective database of patients who underwent ESG at our tertiary referral center between October 2016 and March 2019.Methods: All consecutive patients undergoing upper endoscopy (EGD) preoperatively and 6 and 12 months after ESG were included. The upper gastrointestinal tract was evaluated for mucosal abnormalities and biopsies were systematically taken.Results: Eighty-six patients were included. EGD results were as follows: esophagitis decreased from 14% preoperatively to 3.6% and 1.2% at 6-and 12-month FU, respectively (P = .001); 19.8% of patients presented preoperatively a type I hiatal hernia <4 cm and showed no size increment or de novo hiatal hernia at 6- and 12-months. The rate of preoperative hyperemic (23.2%) and erosive (3.5%) gastropathy decreased to 9.5% and 1.2% at 6 months and 17.4% and 1.2% at 12 months, respectively. Gastric ulcer (4.7%), duodenal hyperemic mucosa (1.2%) and duodenal micro-ulcerations (2.3%) detected preoperatively were not present at 6- and 12-month EGD. The rate of histopathological disease, which was 68.1% preoperatively, dropped to 29.2% at 12 months, chronic gastritis decreased from 40.3% to 26.4%, acute gastritis from 9.7% to 0%, and acute inflammation on chronic gastritis from 18% to 2.8% (P < .001).Conclusion: ESG is a safe procedure that does not promote the new onset of macroscopic and histopathologic abnormalities within 1-year follow-up. (C) 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Lingua originaleEnglish
pagine (da-a)1294-1301
Numero di pagine8
RivistaSurgery for Obesity and Related Diseases
Volume17
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Bariatric endoscopy
  • Obesity
  • Endoscopic sleeve gastroplasty

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