Endoscopic pyloric suturing to facilitate weight loss: a canine model.
BACKGROUND
More than 66% of adults in United States are overweight or obese.


OBJECTIVE
To decrease gastric emptying and cause early and prolonged satiety by endoscopically narrowing the gastric pylorus.


METHODS
Thirteen dogs were randomized into 3 groups (suture, sham, and control).


METHODS
Animal facility.


METHODS
Sutures were placed across the pylorus in the 7 dogs in the suture group by using an endoscopic suturing device. Three sham dogs had endoscopy without suturing, and 3 control dogs did not have any intervention.


METHODS
Gastric emptying studies were conducted on all of the dogs by using 13C-octanoic acid breath tests. All dogs were monitored for daily food intake and weight gain/loss.


RESULTS
The suture dogs decreased their food consumption by 48% (P < .02), whereas the sham and control dogs showed 9.5% increase (P = .16). The suture dogs lost 12.7% (P = .001) of their initial body weight, whereas the sham and control dogs gained 13.4% (P = .03). There was a delay in gastric emptying between the presuturing baseline and last postsuturing measurement by 30.75% (P = .005) in the suture dogs. In the sham plus control dogs, there was a delay in gastric emptying during the same period by only 6.75% (P = .55).


CONCLUSIONS
Long-term efficacy of the sutures was not evaluated.


CONCLUSIONS
There was a significant weight loss and decreased food consumption along with a significant prolongation of gastric emptying in the suture dogs compared with the sham and control dogs.
Vegesna
Anil
A
Section of Gastroenterology, Department of Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA.
Korimilli
Annapurna
A
Besetty
Ramaseshai
R
Bright
Lewis
L
Milton
April
A
Agelan
Alexis
A
McIntyre
Karen
K
Malik
Aslam
A
Miller
Larry
L
D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology; D015391:Gastroplasty / Q000379:methods*; D050177:Overweight / Q000503:physiopathology / Q000601:surgery*; D011708:Pylorus / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*