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- Title
Brazilian Consensus on Endoscopic Sleeve Gastroplasty.
- Authors
Neto, Manoel Galvão; Silva, Lyz Bezerra; de Quadros, Luiz Gustavo; Grecco, Eduardo; Filho, Admar Concon; de Amorim, Artagnan Menezes Barbosa; de Santana, Marcelo Falcao; dos Santos, Newton Teixeira; de Lima, Joao Henrique Felicio; de Souza, Thiago Ferreira; de Morais, Helmut Wagner Poti; Vieira, Felipe Matz; Moon, Rena; Teixeira, André F.; for the Brazilian Endoscopic Sleeve Gastroplasty Collaborative; Alexandre, Adriano Tomas Vasconcelos; de Almeida, Leonardo Salles; Arnoni, Jose Rubes; Bueno, Fermanda Nascimento; Cantanhebe, Keila Regina Matos
- Abstract
Purpose: Bariatric endoscopy is a less invasive approach for obesity management, with better efficacy than pharmacological treatment and low morbidity. Endoscopic sleeve gastroplasty (ESG) is the remodeling of the stomach using a suturing device showing technical feasibility, safety, and sustained weight loss. With growing numbers of procedures worldwide, there is a need to standardize the procedure. Materials and Methods: A consensus meeting was held in São Caetano do Sul-SP, Brazil, in June 2019, bringing together 47 Brazilian endoscopists with experience in ESG from all regions of the country. Topics on indications and contraindications of the procedure, pre-procedure evaluation and multidisciplinary follow-up, technique and post-procedure follow-up, and training requirements were discussed. An electronic voting was carried, and a consensus was defined as ≥ 70% agreement. Results: The panel's experience consisted of 1828 procedures, with a mean percentage total body weight loss (TBWL) of 18.2% in 1 year. Adverse events happened in 0.8% of the cases, the most common being hematemesis. The selected experts discussed and reached a consensus on several questions concerning patient selection, contraindications for the procedure, technical details such as patient preparation, procedure technique, and patient follow-up. Conclusions: This consensus establishes practical guidelines for performance of ESG. The experience of 1828 procedures shows the expertise of the selected specialists participating in this consensus statement. The group's experience has a satisfactory weight loss with low adverse events rate. The main points discussed in this paper may serve as a guide for endoscopists performing ESG. Practical recommendations and technique standardization are described.
- Subjects
SAO Paulo (Brazil); ELECTRONIC voting; WEIGHT loss; BODY weight; PATIENT selection; HEMATEMESIS
- Publication
Obesity Surgery, 2021, Vol 31, Issue 1, p70
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-020-04915-4