Endoscopic Sleeve Gastroplasty Is Feasible, Safe, and Effective in a Non-academic Setting: Short-Term Outcomes from a Community Gastroenterology Practice

Background and Aims Endoscopic sleeve gastroplasty (ESG) has demonstrated promising weight loss results with fewer adverse events and less new-onset gastroesophageal reflux disease (GERD) compared to laparoscopic sleeve gastrectomy. Publications on ESG have exclusively described the experience at large academic medical centers with little known about the implementation and outcomes of this procedure in community practice. Methods We conducted a retrospective study of consecutive patients who underwent ESG at a private, community-based gastroenterology practice. Total body weight loss (TBWL), procedure duration, improvement in metabolic comorbidities, and adverse event (AE) rate and severity were assessed. Results One hundred patients underwent ESG (86 women, mean age 45 +/- 9 years) and were analyzed. Procedure duration was 59 +/- 33 min with an improvement in procedural efficiency from the first quartile (mean 105 min) to the fourth quartile (mean 38 min). Mean 12-month TBWL was 29.80 +/- 11.46 kg (23.1 +/- 7.5%), with excess weight loss of 66.1 +/- 21.5%. Over this time period, mean change in BMI was 9.43 +/- 0.22. A multiple linear regression model found that higher starting weight (P < 0.05) and absence of suture reinforcement (P = 0.037) were associated with increased TBWL at 3 months. Fourteen of 20 cases of hypertension, and 5 of 10 cases of dyslipidemia, were in complete remission by post-procedure month 3. Conclusions ESG performed in a community gastroenterology practice demonstrated comparable clinical outcomes to large tertiary referral centers. TBWL and excess body weight loss either met or exceeded previously reported data from these centers.