Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study

Gastrointest Endosc. 2019 Apr;89(4):782-788. doi: 10.1016/j.gie.2018.08.030. Epub 2018 Aug 25.


Background and aims: Endoscopic sleeve gastroplasty (ESG) reduces the gastric lumen to a size comparable with that of laparoscopic sleeve gastrectomy (LSG). However, there is a paucity of research comparing outcomes between the 2 procedures. Our study compared the 6-month weight loss outcomes and adverse events of ESG with LSG in a case-matched cohort.

Methods: We retrospectively reviewed prospectively collected data for patients undergoing ESG or LSG at a single academic center. Weight was recorded at 1 and 6 months postprocedure, and percent total body weight loss (%TBWL) was calculated. Adverse events and new-onset Gastroesophageal Reflux Disease (GERD) were also recorded.

Results: A total of 54 ESG patients were matched with 83 LSG patients by age, sex, and body mass index. The proportion of patients with GERD at baseline was similar in the 2 groups (16.7% in ESG group vs 25.3% in LSG group, P = .27). At the 6-month follow-up, %TBWL (compared with baseline) was significantly lower in the ESG group compared with the LSG group (17.1% ± 6.5% vs 23.6% ± 7.6%, P < .01). ESG patients had significantly lower rates of adverse events compared with LSG patients (5.2% vs 16.9%, P < .05). New-onset GERD was also significantly lower in the ESG group compared with the LSG group (1.9% vs 14.5%, P < .05).

Conclusions: ESG, a minimally invasive same-day procedure, achieved less weight loss at 6 months than LSG, with the caveat that LSG caused more adverse events and new-onset GERD than ESG.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Gastrectomy / methods*
  • Gastroesophageal Reflux / epidemiology
  • Gastroplasty / methods*
  • Gastroscopy / methods*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / surgery*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss*
  • Young Adult