Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis

Abdellah Hedjoudje, Barham K. Abu Dayyeh, Lawrence J. Cheskin, Atif Adam, Manoel Galvão Neto, Dilhana Badurdeen, Javier Graus Morales, Adrian Sartoretto, Gontrand Lopez Nava, Eric Vargas, Zhixian Sui, Lea Fayad, Jad Farha, Mouen A. Khashab, Anthony N. Kalloo, Aayed R. Alqahtani, Christopher C. Thompson, Vivek Kumbhari

Research output: Contribution to journalReview articlepeer-review

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

Original languageEnglish (US)
Pages (from-to)1043-1053.e4
JournalClinical Gastroenterology and Hepatology
Volume18
Issue number5
DOIs
StatePublished - May 2020

Keywords

  • Complication
  • Endoscopy
  • Overweight
  • Stomach

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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