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. 2023 Jun;68(6):2285-2290.
doi: 10.1007/s10620-023-07893-6. Epub 2023 Mar 18.

Endoscopic Sleeve Gastroplasty Assisted by Postgraduate Medical Trainees: An Early Safety Analysis

Anuragh Gudur  1 , Alexander Podboy  2
Affiliations

Endoscopic Sleeve Gastroplasty Assisted by Postgraduate Medical Trainees: An Early Safety Analysis

Anuragh Gudur et al. Dig Dis Sci. 2023 Jun.

Abstract

Background: Endoscopic sleeve gastroplasty (ESG) is an emerging bariatric intervention with comparable safety and efficacy to surgical sleeve gastrectomy (SG). As ESG is utilized more commonly, postgraduate medical training in bariatric endoscopy has expanded to train physicians in this technically complex procedure. Prior studies have analyzed procedural outcomes of bariatric surgery assisted by medical trainees, but no such analysis has been performed with ESG.

Aims: This study aims to evaluate the short-term safety of ESG in cases assisted by postgraduate medical trainees.

Methods: We retrospectively analyzed over 2000 patients in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from 2016 to 2020. Cases of ESG performed with the assistance of postgraduate medical trainees (residents and/or fellows) were propensity matched (1:1) to cases of ESG performed without trainee involvement. We compared the occurrences of adverse events (AE), readmissions, re-interventions, and re-operations between these matched cohorts of ESG. Secondary outcomes included procedure time, length of stay (LOS), and total body weight loss (TBWL).

Results: A total of 1204 cases of ESG assisted by postgraduate medical trainees were compared to 1204 matched cases without trainee involvement. Procedures performed by attending physicians alone had fewer AE (0.7% vs 2.0%, p = 0.014) and rates of re-operations (0.8% vs 2.4%, p = 0.004) compared to procedures assisted by trainees. There were no significant differences in readmissions (4.0% vs 4.4%, p = 0.684) or reinterventions (3.8% vs. 4.6%, p = 0.416) at 30 days. Cases involving trainees had longer duration (71 vs 51 min, p < 0.001) and LOS (1.11 vs. 0.5 days, p < 0.001). TBWL at 30 days was greater in procedures performed with trainees (4.1% vs 3.4%, p = 0.033).

Conclusion: ESG is a technically complex procedure that can be safely performed with trainee assistance. Academic medical centers may continue supporting the expansion of training in bariatric endoscopy as an advanced endoscopic skill.

Keywords: Bariatric endoscopy; Endoscopy sleeve gastroplasty; Fellowship; Obesity.

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References

    1. Ward ZJ, Bleich SN, Cradock AL et al. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med 2019;381:2440–2450. - DOI - PubMed
    1. Afshin A, Forouzanfar MH, GBD 2015 Obesity Collaborators et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017;377:13–27. https://doi.org/10.1056/NEJMoa1614362 . - DOI - PubMed
    1. Mehta A, Sharaiha RZ. Bariatric and metabolic endoscopy: impact on obesity and related comorbidities. Therapeutic Advances in Gastrointestinal Endoscopy. 2021. https://doi.org/10.1177/26317745211019156 . - DOI - PubMed - PMC
    1. Hedjoudje A, Abu Dayyeh BK, Cheskin LJ et al. Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol 2020;18:1043-1053.e4. https://doi.org/10.1016/j.cgh.2019.08.022 . - DOI - PubMed
    1. Kumar N, Dayyeh BA, Dunkin BJ et al. ABE/ASGE position statement on training and privileges for primary endoscopic bariatric therapies. Gastrointest Endosc 2020;91:1230–1233. https://doi.org/10.1016/j.gie.2019.07.017 . - DOI - PubMed

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