LAUSR

Introduction ESG is an effective treatment option for obesity. However, data comparing its efficacy to bariatric surgery is scarce. We aim to compare the effectiveness and safety of ESG to LSG and LGCP at 2-years. Methods We reviewed 353 patient records and identified 296 patients who underwent ESG (n=199), LSG (n=61), and LGCP (n=36) at 4-centers in Spain between 2014 to 2016. We compared their total body weight loss (%TBWL) and safety over 2-years. We used a linear mixed model (LMM) to analyse repeated measures of weight loss outcomes at 6, 12, 18, and 24-months for comparison between the three procedures. Results Among the 296 patients, 210 (ESG-135, LSG-43, LGCP-32) reached 1-year and 102 (ESG-46, LSG-34, LGCP-22) patients completed 2-years follow-up. The mean(SD) BMI was 39.6(4.8) kg/m2. There was no difference in the age, sex, and BMI between the groups. In LMM analysis, adjusting for age, sex, and initial BMI, we found ESG had a significantly lower TBWL, %TBWL, and BMI decline compared to LSG and LGCP at all time points (p=0.001). The adjusted mean %TBWL at 2-years with ESG, LSG, and LGCP was 18.5%, 28.3%, and 26.9%, respectively. However, ESG, as compared to LSG and LGCP, had a shorter inpatient stay (1 vs.3 vs. 3 days, p<0.001) and lower complication rate (0.5% vs.4.9% vs. 8.3%, p=0.006). Conclusion All three procedures induced significant weight loss in obese patients. Although the weight loss was lower with ESG compared to other techniques, it displayed a better safety profile and shorter hospital stay.