INTRODUCTION Endoscopic sleeve gastroplasty (ESG) has gained popularity over the past decade and has been adopted in both academic and private institutions globally. We present outcomes of the largest cohort of patients from the United States undergoing ESG and evaluate these according to obesity class. METHODS We performed a retrospective analysis of adult patients who underwent ESG. Medical information was abstracted from the electronic record with weight records up to two years after ESG. Percent total body weight loss (%TBWL) at 6, 12, 18, and 24 months were calculated based on baseline weight at procedure. SPSS (version 29.0) was used for all statistical analyses. RESULTS A total of 1506 patients from 7 sites were included (501 Class I obesity, 546 Class II and 459 with Class III). Baseline demographics differed according to obesity class due to differences in age, BMI, height, sex distribution, and race. As early as 6 months post ESG, mean BMI for each class dropped to the next lower class and remained there through 2 years. %TWBL achieved in the Class III group was significantly greater when compared with other classes at all time points. At 12 months, 83.2% and 60.9% of patients had ≥10% and ≥ 15% TBWL for all classes. There were no differences in adverse events between classes. CONCLUSION Real world data from a large cohort of patients of all BMI classes across the US shows significant and sustained weight loss with ESG. ESG is safe to perform in a higher obesity class with acceptable mid-term efficacy.

中文翻译：

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美国临床环境中按肥胖等级划分的内窥镜袖状胃成形术的表现。

简介 内窥镜袖状胃成形术 (ESG) 在过去十年中越来越受欢迎，并已被全球学术和私人机构采用。我们展示了来自美国的最大一批接受 ESG 的患者的结果，并根据肥胖类别对其进行评估。方法 我们对接受 ESG 的成年患者进行了回顾性分析。ESG 后两年内，从带有体重记录的电子记录中提取医疗信息。根据手术时的基线体重计算 6、12、18 和 24 个月时的总体体重减轻百分比 (%TBWL)。SPSS（29.0 版）用于所有统计分析。结果 共纳入来自 7 个地点的 1506 名患者（501 名 I 级肥胖患者、546 名 II 级肥胖患者和 459 名 III 级肥胖患者）。由于年龄、体重指数、身高、性别分布和种族的差异，不同肥胖等级的基线人口统计数据也有所不同。早在 ESG 后 6 个月，每个类别的平均 BMI 就下降到下一个较低的类别，并保持该水平长达 2 年。在所有时间点，与其他班级相比，III 级组取得的 %TWBL 均显着更高。12 个月时，所有类别中 83.2% 和 60.9% 的患者 TBWL ≥ 10% 和 ≥ 15%。不同类别之间的不良事件没有差异。结论 来自美国所有 BMI 类别的大量患者的真实世界数据显示，ESG 显着且持续的体重减轻。ESG 在较高肥胖级别中是安全的，且中期疗效可接受。