Year 2017 / Volume 109 / Number 5
Original
Multicenter study on the safety of bariatric endoscopy

350-357

DOI: 10.17235/reed.2017.4499/2016

Eduardo Espinet Coll, Javier Nebreda Durán, Gontrand López-Nava Breviere, Julio Ducóns García, Manuel Rodríguez-Téllez, Javier Crespo García, Carlos Marra-López Valenciano,

Abstract
Introduction: Bariatric endoscopy includes a series of specific techniques focused on the management of obese patients. As a quality criterion, safety as expressed by a minimal incidence of serious complications is required in addition to efficacy. Methods: A descriptive, retrospective, multicenter review of the experience recorded at seven hospitals included in the Grupo Español de Endoscopia Bariátrica (GETTEMO) in order to document the incidence, cause, and resolution (including legal consequences) of serious complications reported for each bariatric technique, and according to endoscopist expertise. Results: In all, 6,771 bariatric endoscopic procedures were collected, wherein 57 serious complications (0.84%) were identified. Balloons: Orbera®-Medsil®, 5/5,589; Spatz2® (older model): 44/225; Heliosphere®: 1/70; Obalon®: 0/107. Sutures: POSE®, 5/679; sleeve gastroplasty with Apollo® system: 0/55. Prostheses: Endobarrier®: 2/46. All complications were resolved with medical/endoscopic management except for five cases (0.07%) that required surgery. A single lawsuit occurred (esophageal perforation with Spatz2® balloon), which had a favorable outcome. There was no mortality, and apparently no differences were found according to endoscopist expertise level. Conclusions: In our multicenter experience, bariatric endoscopy may be considered as a safe procedure (0.84% of serious complications in all). However, some devices may induce a higher proportion of complications, such as 19.55% for Spatz2® balloons (already replaced) or 4.34% for Endobarrier® sleeves (at the upper limit of accepted safety), although our experience with the latter is limited. All complications were resolved with conservative medical management, and only exceptionally required surgery (0.07%). No technique-related mortality was seen, and only one lawsuit occurred. Further evolutionary studies are required on the novel endoscopic techniques presently emerging to authenticate our results.
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Espinet Coll E, Nebreda Durán J, López-Nava Breviere G, Ducóns García J, Rodríguez-Téllez M, Crespo García J, et all. Multicenter study on the safety of bariatric endoscopy. 4499/2016


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Publication history

Received: 13/06/2016

Accepted: 31/01/2017

Online First: 17/03/2017

Published: 03/05/2017

Article revision time: 223 days

Article Online First time: 277 days

Article editing time: 324 days


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