Background and Objectives: The primary objective was to compare 12-month percentage total body weight loss (%TBWL) after endoscopic sleeve gastroplasty (ESG) and laparoscopic sleeve gastrectomy (LSG); secondary objectives were to compare metabolic, safety, and reflux outcomes, and an exploratory objective was to describe early predictors of suboptimal response. Materials and Methods: This retrospective single-center cohort included 28 ESG and 31 LSG patients treated between January 2019 and December 2022. The primary outcome was %TBWL at 12 months. Because the groups overlapped only within a limited body mass index (BMI) range, the adjusted comparison was repeated in patients with a BMI of 35–44.9 kg/m², in whom both procedures were performed. Results: Baseline BMI was lower in the ESG group (36.8 versus 44.2 kg/m²), and class III obesity was present in 14.3% of ESG and 77.4% of LSG patients. Twelve-month %TBWL was 17.1% after ESG and 30.6% after LSG. The multiple-imputation adjusted difference favored LSG by 14.9 percentage points (95% confidence interval [CI] 11.0–18.8; p < 0.001) and 13.9 points (95% CI 9.2–18.6) in the BMI-overlap subset. Inverse probability weighting retained only 25 patients with residual imbalance and is reported solely as a supplementary sensitivity analysis. In secondary analyses, LSG was associated with larger reductions in glycated hemoglobin and alanine aminotransferase. Median hospital stay was shorter after ESG (1.2 versus 2.9 days). New-onset or worsened reflux occurred in 14.3% and 32.3%, respectively (log-rank p = 0.140; unadjusted hazard ratio 2.33, 95% CI 0.73–7.45; exploratory covariate-adjusted and Firth-penalized estimates were imprecise). Serious adverse events occurred in 3.6% and 6.5%. In an exploratory, internally validated model, 3-month weight loss was associated with suboptimal 12-month response (optimism-corrected area under the curve 0.878). Conclusions: LSG was associated with greater weight loss and selected metabolic improvements, whereas ESG was associated with shorter hospitalization. Because the groups differed substantially at baseline, overlapped only within a narrow BMI range, and were small, the ESG–LSG comparison is exploratory: these associations apply to that overlap zone, should not be interpreted as comparative-effectiveness estimates, and provide limited evidence for clinical procedure selection. Reflux comparisons and the prediction model are exploratory and require confirmation in larger cohorts.

The relationship between active Helicobacter pylori infection and clinical oral findings remains uncertain. This study compared oral mucosal lesions, oral symptoms and gingival bleeding between adults with and without active infection.This retrospective cross-sectional study included 61 adults examined between March and September 2025 and selected nonconsecutively according to their willingness to participate (83 eligible patients approached; 22 declined). Participants referred for non-invasive H. pylori testing were classified as infected (n = 29) or test-negative (n = 32) by urea breath or monoclonal stool antigen testing. Recorded oral examinations included gingival screening of 318 index teeth and 1272 sites. Firth penalized logistic regression evaluated mucosal lesions; mixed models and generalized estimating equations addressed clustered gingival outcomes. At least one mucosal lesion was present in 55.2% of infected and 21.9% of test-negative participants (difference 33.3 percentage points, 95% confidence interval [CI] 8.9–53.0; p = 0.007). The adjusted odds ratio was 5.68 (95% CI 1.67–22.84; p = 0.005; 4.61 after shrinkage for optimism). Oral burning was reported by 31.0% versus 3.1% (9 versus 1 participant; p = 0.004), whereas halitosis, dysgeusia and xerostomia did not differ significantly. The adjusted site-level odds ratio for bleeding on probing was 1.93 (95% CI 1.15–3.25) and was attenuated after exclusion of current smokers (1.55; 95% CI 0.91–2.67). Active H. pylori infection was associated with the presence of oral mucosal lesions in this small sample with a test-negative comparator group; the associations with oral burning and gingival bleeding rested on few events or were sensitive to smoking status and should be regarded as hypothesis-generating. The cross-sectional design cannot establish causation, and larger longitudinal studies with confirmed infection status are needed.