Bariatric Endoscopy Predictive Variables Of Adherence To 4 Different Procedures In 962 Patients

Abstract

Objectives: New bariatric endoscopic techniques (BET) have been developed, that could help in the treatment of obesity. These minimally invasive methods, such as Gastroplasty techniques (Endoscopic sleeve gastroplasty (APOLLO gastroplasty) and Primary Obesity Surgery Endolumenal (POSE method)) and Intragastric Balloon (IGB) (Orbera and Dual), have shown effectiveness and safety . However limited data is available over characteristics of individuals who would most benefit from a BET. The objective of the study is to investigate predictor factors of adherence to a weight loss and educational program at 1 year off follow-up after BET in the Bariatric Endoscopy Unit of Madrid HM Sanchinarro University Hospital during the past 3 years. Material and Methods: Prospective single-center study over 962 patients (271 men) with at least 1 year of follow-up. 389 patients receiving a Orbera IGB, 92 patients receiving a Dual IGB, 247 patients undergoing the Apollo gastroplasty and 234 undergoing the Pose technique, were followed for 12 months. Initial BMI was 37.8 ± 5.7, and initial age 45.3±11.2 years. Follow-up was carried out by a multidisciplinary team (endocrinologist, psychologist) biweekly. Patients were segregated with respect to weight loss treatment completion at 1 year in: ‘successful follow-up’ (patient that continue the follow-up) or ‘dropped-out follow-up’ (patient that dropped-out the program). Logistic regression analysis was used to evaluate the treatment adherence and the variables included were: gender, age, initial BMI and procedure type (segregated in IGB, or Gastroplasty techniques). Results: 480 patients (50% of the sample) reached one year of follow-up. 2/3 of the sample achieved > 10% and 1/3 > 20% of %TBWL. Those patients who completed the one year, were more frecuent woman, older than 45 year, with BMI 40 kg/m2 or higher and with Gastroplasty techniques performed (versus IGB) (Table 1).

Variables that influence complete the program successfully at one year were gender, baseline BMI, and procedure type (Table 2). Factors predictive of 1 year completion were: gender (females responded better), initial BMI (higher index, higher completion), and type of procedure (endoscopy gastroplasty procedures longer follow-up). Initial age did not influence. Key findings: Patients undergoing endoscopic gastroplasty (vs IGB), women and with higher initial BMI show more possibilities of adherence at 1 year follow-up after bariatric endoscopy techniques. Future studies may need to focus on determining the success and completion rates of weight reduction in the bariatric endoscopic procedures