Post-sleeve gastrectomy weight loss: Role of botulinum toxin and semaglutide injections.

BACKGROUND AND STUDY AIMS: Comparison of the therapeutic effects of endoscopic botulinum toxin (BTX) injection and semaglutide (SME) injection in treatment of patients with obesity and weight regain after laparoscopic sleeve gastrectomy (LSG). PATIENTS AND METHODS: The injection method for botulinum toxin is to dilute 300 U of type A botulinum toxin with 20 mL of physiological saline. Injections were made in a grid pattern throughout the antrum and body (20 injection points total), with 1 mL of drug injected at every point. The application method for semaglutide injection is to start at 0.25 mg once a week and increase by 0.25 mg every 3 weeks until the patient can tolerate the maximum dose (1.0 mg qw), for a total of 6 months. RESULTS: The weight loss effect of the SME group was significantly better than that of the LSG+SME group because the SME group achieved significantly greater weight loss at 2 months than the LSG+SME group. No significant difference was seen between any other pair of groups. CONCLUSIONS: Endoscopic botulinum toxin injection can be a safe and effective treatment for weight regain after LSG.