Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients.
BACKGROUND
Bariatric surgery for severe obesity has demonstrated significant health benefits, but it is not without complications. Transoral approaches to weight loss offer a minimally invasive option.


OBJECTIVE
To evaluate the safety and feasibility of a transoral suturing procedure for weight loss.


METHODS
Single-center, uncontrolled study with a 1-year follow-up.


METHODS
Hospital de Clinicas, Caracas, Venezuela.


METHODS
Sixty-four patients (mean age [SD] 31.5 +/- 10.1 years, range 16-62 years; mean (SD) preoperative body mass index [BMI] 39.9 +/- 5.1 kg/m(2), range 28.0-60.2 kg/m(2)) were enrolled between 2003 and 2005.


METHODS
Endoluminal vertical gastroplasty by using a continuous suture pattern to treat obesity.


METHODS
Short-term complication monitoring and patient weight before the procedure and at 1, 3, and 12 months after the procedure.


RESULTS
The outpatient procedures were performed in approximately 45 minutes. Patients had a significant reduction in BMI at 12 months (mean [SD] BMI 39.9 +/- 5.1 kg/m(2) vs 30.6 +/- 4.7 kg/m(2); P < .001) and a percentage of excess weight loss (%EWL) (SD) of 21.1 +/- 6.2, 39.6 +/- 11.3, and 58.1 +/- 19.9 at 1, 3, and 12 months, respectively. By comparing the study's subpopulations, group I (baseline BMI >or=40 kg/m(2), n = 33), group II (baseline BMI 35-40 kg/m(2), n = 19), and group III (baseline BMI <35 kg/m(2), n = 12) demonstrated a %EWL (SD) of 48.9 +/- 10.7, 56.5 +/- 13.9, and 85.1 +/- 24.0, respectively, at 12 months after the procedure (P = .037 when comparing group I vs II; P < .001 when comparing group II vs III and group I vs III). No patients experienced any serious adverse events.


CONCLUSIONS
This study represents a single center's clinical experience, with no sham control.


CONCLUSIONS
Endoluminal vertical gastroplasty by using a continuous suture pattern is associated with significant weight loss. Additional studies are needed to demonstrate the procedure's long-term safety and efficacy.
Fogel
Roberto
R
Department of Gastroenterology, Hospital de Clinicas Caracas, Caracas, Venezuela.
De Fogel
Juana
J
Bonilla
Ydaly
Y
De La Fuente
Rafael
R
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011336:Probability; D018570:Risk Assessment; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014687:Venezuela; D015431:Weight Loss