ABSTRACT
Background and study aims ESG is an effective and safe medium-term procedure for obesity treatment. A variety of suture patterns have been reported. We aimed to compare whether there are differences in efficacy depending on suture pattern used. Patients and methods Retrospective and comparative review of 5 years of prospectively collected data, including consecutive obese patients undergoing ESG at two collaborative centers. Primary outcomes included weight loss (mainly % total body weight loss [TBWL] and % exces weight loss [EWL]) at 12 months and safety profile. We compared them according to three suture patterns (transverse bilinear [TBp], longitudinal [Lp] and transverse monolinear [TMp]), and number of sutures (4â-â7) and stitches (<â25, 25 to 30 and >â30) applied. Evolution of major obesity-associated morbidities (hypertension, dyslipidemia, Type 2 diabetes mellitus (T2DM), sleep obstructive apnea syndrome, and arthropathy) were also described. Results 88 patients (mean age 46.1±12.3 years, 69.3â% female) underwent ESG. Mean body mass index (BMI) at baseline was 39.40â±â4.69âkg/m². At 1 year, %TBWL was 17.36â±â6.09â% (%EWL 46.41±20.6â%) with TBWL >â10â% in 95.5â% of patients (EWLâ>â25â% in 94.3â% of patients). According to pattern, there were no differences in %TBWL but there were in %EWL (43.7â±â20.4â%, 59.8â±â18.9â% and 45.4â±â14.9â% in TBp, Lp and TMp patterns, respectively) ( P â=â0.034). No differences were found related to number of sutures (mean 5.2â±â0.73, râ=â4â-â7) or stitches (mean 27.4â±â6.50, râ=â18â-â50) applied. Forty-three of 72 (59.7â%) major comorbidities were resolved. No serious adverse events were observed with any pattern. Conclusions ESG is an effective procedure at 12-month follow-up for weight loss and comorbidity resolution. All three analyzed patterns are safe and effective without differences in %TBWL, but there was a slight increase in %EWL in Lp, regardless of the number of sutures or stitches applied.
ABSTRACT
BACKGROUND: The most critical factor determining the quality of colonoscopy results is the extent of bowel cleansing. AIM: This observational post-marketing study evaluated the efficacy, acceptability and safety of a range of the most commonly used bowel cleansing solutions in routine clinical practice. PATIENTS: Patients undergoing diagnostic, preventive or follow-up colonoscopy were recruited from 7 centres in Italy, Spain and Greece. METHODS: Quality of bowel preparation was assessed on a 5-point scale and included evaluation of visible bowel surface area and the amount and consistency of residual fluid. Patients evaluated ease of use and palatability. RESULTS: A total of 437 patients took part. Klean-Prep, the most commonly used preparation in this evaluation, achieved the highest score for quality of bowel cleansing and was rated as good or excellent in 72.0% of patients. In dosage-compliant patients, Klean-Prep showed better results in comparison to Fleet Phosphosoda (p < 0.05) in the maximum bowel level reached in the intestine during colonoscopy examinations. All of the bowel cleansing solutions were well tolerated. CONCLUSION: The polyethylene glycol-based preparations provided the most adequate cleansing and, of these, Klean-Prep provided the highest "good" or "excellent" level of bowel preparation.