Abdellah Hedjoudje1, Barham K Abu Dayyeh2, Lawrence J Cheskin3, Atif Adam4, Manoel Galvão Neto5, Dilhana Badurdeen1, Javier Graus Morales6, Adrian Sartoretto7, Gontrand Lopez Nava8, Eric Vargas1, Zhixian Sui9, Lea Fayad1, Jad Farha1, Mouen A Khashab1, Anthony N Kalloo1, Aayed R Alqahtani10, Christopher C Thompson11, Vivek Kumbhari12. 1. Division of Gastroenterology, Johns Hopkins Medicine, Baltimore, Maryland. 2. Mayo Clinic School of Medicine, Rochester, Minnesota. 3. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 4. Johns Hopkins Weight Management Center, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 5. Herbert Wertheim College of Medicine, Florida International University, Miami, Florida; Endovitta Institute, São Paulo, Brazil. 6. Instituto Médico Europeo de la Obesidad, Madrid, Spain. 7. BMI Clinic, Double Bay, Australia. 8. Bariatric Endoscopy Unit, Madrid Sanchinarro University Hospital, Madrid, Spain. 9. BMI Clinic, Double Bay, Australia; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia. 10. Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; New You Medical Center, Riyadh, Saudi Arabia. 11. Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts. 12. Division of Gastroenterology, Johns Hopkins Medicine, Baltimore, Maryland. Electronic address: vkumbhari@gmail.com.
Abstract
BACKGROUND & AIMS: Bariatric surgery is the most successful treatment for obesity. However, many patients avoid surgery due to its perceived invasive nature and fear of complications. Endoscopic sleeve gastroplasty (ESG) is a seemingly less invasive option for patients with obesity. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of ESG in adults. METHODS: We searched MEDLINE, Embase, Web of Science, and Cochrane Library through July 2019. Investigated outcomes included the percent total body weight loss (TBWL), body mass index reduction, percent excess weight loss (EWL), and adverse events. RESULTS: We extracted data from 8 original studies, published from 2016 through 2019, which included a total of 1772 patients. At 6 months, mean TBWL was 15.1% (95% CI, 14.3-16.0), mean decrease in body mass index was 5.65 kg/m2 (95% CI, 5.07-6.22), and mean excess weight loss was 57.7% (95% CI, 52.0-63.4). Weight loss was sustained at 12 months and 18-24 months with a TBWL of 16.5% (95% CI, 15.2-17.8) and 17.2% (95% CI, 14.6-19.7), respectively. The pooled post-ESG rate of severe adverse events was 2.2% (95% CI, 1.6%-3.1%), including pain or nausea requiring hospitalization (n = 18, 1.08%), upper gastrointestinal bleeding (n=9, 0.56%), and peri-gastric leak or fluid collection (n = 8, 0.48%). CONCLUSIONS: In a systematic review and meta-analysis, we found ESG to produce clinically significant weight loss that was reproducible among independent centers and to have a low rate of severe adverse events. ESG appears to be an effective intervention for patients with obesity, although comparative studies and randomized controlled trials are necessary. PROSPERO Identifier: CRD42019121921.
BACKGROUND & AIMS: Bariatric surgery is the most successful treatment for obesity. However, many patients avoid surgery due to its perceived invasive nature and fear of complications. Endoscopic sleeve gastroplasty (ESG) is a seemingly less invasive option for patients with obesity. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of ESG in adults. METHODS: We searched MEDLINE, Embase, Web of Science, and Cochrane Library through July 2019. Investigated outcomes included the percent total body weight loss (TBWL), body mass index reduction, percent excess weight loss (EWL), and adverse events. RESULTS: We extracted data from 8 original studies, published from 2016 through 2019, which included a total of 1772 patients. At 6 months, mean TBWL was 15.1% (95% CI, 14.3-16.0), mean decrease in body mass index was 5.65 kg/m2 (95% CI, 5.07-6.22), and mean excess weight loss was 57.7% (95% CI, 52.0-63.4). Weight loss was sustained at 12 months and 18-24 months with a TBWL of 16.5% (95% CI, 15.2-17.8) and 17.2% (95% CI, 14.6-19.7), respectively. The pooled post-ESG rate of severe adverse events was 2.2% (95% CI, 1.6%-3.1%), including pain or nausea requiring hospitalization (n = 18, 1.08%), upper gastrointestinal bleeding (n=9, 0.56%), and peri-gastric leak or fluid collection (n = 8, 0.48%). CONCLUSIONS: In a systematic review and meta-analysis, we found ESG to produce clinically significant weight loss that was reproducible among independent centers and to have a low rate of severe adverse events. ESG appears to be an effective intervention for patients with obesity, although comparative studies and randomized controlled trials are necessary. PROSPERO Identifier: CRD42019121921.
Authors: Alia Hadefi; Marianna Arvanitakis; Vincent Huberty; Jacques Devière Journal: United European Gastroenterol J Date: 2020-07 Impact factor: 4.623
Authors: Andrea Telese; Vinay Sehgal; Cormac G Magee; S Naik; S A Alqahtani; L B Lovat; Rehan J Haidry Journal: Clin Transl Gastroenterol Date: 2021-06-18 Impact factor: 4.488