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. 2022 Oct;32(10):3390-3397.
doi: 10.1007/s11695-022-06232-4. Epub 2022 Aug 2.

Outcomes of Endoscopic Sleeve Gastroplasty in the Elder Population

Maria V Matteo  1   2 , Vincenzo Bove  3   4 , Valerio Pontecorvi  3   4 , Martina De Siena  3   4 , Gabriele Ciasca  5   6 , Massimiliano Papi  5   6 , Giulia Giannetti  3   4 , Giorgio Carlino  7 , Marco Raffaelli  8 , Guido Costamagna  3   4 , Ivo Boškoski  3   4
Affiliations

Outcomes of Endoscopic Sleeve Gastroplasty in the Elder Population

Maria V Matteo et al. Obes Surg. 2022 Oct.

Abstract

Purpose: With the aging of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short- and medium-term outcomes of ESG in patients with obesity aged 65 years and older.

Materials and methods: A retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, and the presence of comorbidities were assessed.

Results: Eighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m2. After ESG, the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12, and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12, and 24 months, respectively. The median BAROS score was 3.0, 3.4, and 2.5 at 6, 12, and 24 months, respectively. Six out of twelve patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. Two out of six patients with OSA stopped therapy with CPAP. No adverse events were recorded.

Conclusion: According to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suitable for bariatric surgery because of age and comorbidities.

Keywords: Bariatric endoscopy; Elderly; Endoscopic sleeve gastroplasty; Obesity.

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Conflict of interest statement

Ivo Boškoski is a consultant and research grant holder for Apollo Endosurgery. All the other authors (Maria Valeria Matteo, Vincenzo Bove, Valerio Pontecorvi, Martina De Siena, Gabriele Ciasca, Massimiliano Papi, Giulia Giannetti, Giorgio Carlino, Marco Raffaelli, and Guido Costamagna) have nothing to disclose.

Figures

Fig. 1
Fig. 1
Flowchart for decision making process in the elderly with obesity
Fig. 2
Fig. 2
Bariatric Analysis and Reporting Outcome System BAROS (Morehead-Ardelt quality of life questionnaire — this instrument is copyright protected and licensing for publication in this paper was obtained from Dr. Melodie Kay Moorehead at drmoorehead.com)
Fig. 3
Fig. 3
Box plot analysis of patients’ age (A) and BMI (B) at baseline
Fig. 4
Fig. 4
Time trends of EWL% (A) and TBWL% (B) after ESG in the elderly. The non-linear equation y = a(1 − e−bt) was fitted to the experimental data (dashed lines) and reported on each plot together with confidence and prediction bands
Fig. 5
Fig. 5
Alluvial plot analysis for arterial hypertension (A), OSAS (B), and diabetes (C) in the elderly
See this image and copyright information in PMC

References

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