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

Abstract Introduction 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 (UGI) 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. Settings 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. UGI tract was evaluated for mucosal abnormalities and biopsies were systematically taken. Results Eighty-six patients were included. EGD results were as follow: esophagitis decreased from 14% pre-operatively, to 3.6% and 1.2% at 6- and 12-month FU, respectively (p=0.001); 19.8% of patients presented pre-operatively a type I hiatal hernia (HH) Conclusion ESG is a safe procedure which does not promote the new onset of macroscopic and histopathologic abnormalities within 1-year FU. ID NCT02948621 https://clinicaltrials.gov/ct2/show/NCT02948621?term=NCT02948621&draw=2&rank=1 , NCT03554902 https://clinicaltrials.gov/ct2/show/NCT03554902?term=NCT03554902&draw=2&rank=1 .conclusion