Outcomes of ESG and LSG with 12+ Months of Adjuvant Pre- and Postoperative Multidisciplinary Support

Skye Marshall, Prudence Carr, Tim Keighley, Peter Petocz, Graeme Rich, Felicity Cohen, Asha Soni, Isabella R. Maimone, Flavia Fayet-Moore, Elisabeth Isenring

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Background: Adults with obesity are electing bariatric procedures including the laparoscopic sleeve gastrectomy (SG) and more recently, the incisionless endoscopic sleeve gastroplasty (ESG). However, their efficacy, safety and patient-centered outcomes require further investigation in the Australian setting. To examine the 6- and 12-month weight loss efficacy, safety, and weight-related quality of life (QoL) of adults with obesity who received the ESG or SG bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postoperative support. 
Methods: Two-arm prospective cohort study followed Australian patients who elected the ESG or SG procedure from baseline to 12-months postoperative. Excess weight loss (EWL) was the primary outcome. Secondary outcomes were body composition via dual energy X-ray absorptiometry, weight-related QoL, lipid, glycemic, and hepatic biochemistry, and adverse events. 
Results: 16 (81.2% female; aged 41.4 (SD=10.4)years; BMI=35.5 (SD=5.2)kg/m2) ESG and 45 (84.4% female; aged 40.4 (9.0)years; BMI=40.7 (5.6)kg/m2) SG participants were recruited. At 12-months postprocedure, ESG EWL was 57% (SD: 32%; p<0.01) and SG EWL was 79% (SD: 24; p<0.001). ESG and SG cohorts improved QoL, liver function, and lipid profiles; however, only SG was statistically significant (p<0.001). Both cohorts reduced fat mass (p <0.05). The ESG maintained but SG decreased fat free mass at 6-months (p<0.05). No procedure-related serious adverse events were identified. 
Conclusions: In this setting, the ESG and SG were safe and effective weight loss treatments for obese adults alongside multidisciplinary support. The ESG may confer additional benefits in the retention of fat free mass whilst the LSG may lead to greater overall (fat free and fat mass) weight loss. Further well powered studies are required to confirm these findings.
Video recording of the presentation
Copyright © 2021 Skye Marshall & Felicity Cohen
All rights reserved. 
Reproduced with permission
Original languageEnglish
Publication statusE-pub ahead of print - Nov 2021
EventObesity Week - Virtual , United States
Duration: 1 Nov 20215 Nov 2021


ConferenceObesity Week
Country/TerritoryUnited States
Internet address


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