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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(04): E558-E565
DOI: 10.1055/a-1120-8350
Original article

Outcomes of endoscopic sleeve gastroplasty; how does it compare to laparoscopic sleeve gastrectomy? A systematic review and meta-analysis

Babu P. Mohan‡
1   Internal Medicine, University of Arizona, Banner University Medical Center, Tucson, Arizona, United States
,
Ravishankar Asokkumar‡
2   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Shahab R. Khan
3   Section of Gastroenterology, Rush University Medical Center, Chicago, Illinois, United States
,
Rajesh Kotagiri
1   Internal Medicine, University of Arizona, Banner University Medical Center, Tucson, Arizona, United States
,
Gurusravanan Kutti Sridharan
1   Internal Medicine, University of Arizona, Banner University Medical Center, Tucson, Arizona, United States
,
Saurabh Chandan
4   Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Naveen PG. Ravikumar
5   Internal Medicine, University at Buffalo, Buffalo General Hospital, Buffalo, New York, United States
,
Suresh Ponnada
6   Internal Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, United States
,
Mahendran Jayaraj
7   Department of Gastroenterology and Hepatology, University of Nevada, Las Vegas, Nevada, United States
,
Douglas G. Adler
8   Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, United States
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Abstract

Background and study aims Endoscopic sleeve gastroplasty (ESG) is a novel moderately invasive technique in endo-bariatrics as compared to laparoscopic sleeve gastrectomy (LSG). Data is limited as to its efficacy and safety.

Methods We searched multiple databases from inception through August 2019 to identify studies that reported on ESG in the treatment of obesity. Our goals were to calculate the pooled rates of total weight loss (%TWL), excess weight loss (%EWL), and body mass index (BMI) at 1 month, 6 months, and 12 months with ESG. We included studies that reported on LSG, in a similar time frame as ESG, and compared the 12-month outcomes.

Results From eight studies on ESG (1815 patients), the pooled rates of %TWL at 1 month, 6 months, and 12 months were 8.7 (7.2–10.2), 15.3 (14.1–16.6) and 17.1 (15.1–19.1), respectively. The pooled rates of %EWL at 1 month, 6 months, and 12 months were 31.7 (29.3–34.1), 59.4 (57–61.8) and 63 (51.3–74.6), respectively. The pooled rates of BMI at 1 m, 6 m, and 12 m were 32.6 (31–34.3), 30.4 (29–31.8) and 30 (27.7–32.3, I2 = 97), respectively. At 12 months, the pooled %TWL, %EWL and BMI with LSG (7 studies, 2179 patients) were 30.5 (27.4–33.5), 69.3 (60.1–78.4) and 29.3 (27.1–31.4) respectively. On comparison analysis, %TWL with LSG was superior to ESG (P = 0.001). %EWL and BMI were comparable. All adverse events, bleeding and gastro-esophageal reflux disease were significantly lower with ESG when compared to LSG.

Conclusion ESG demonstrates acceptable weight loss parameters and seems to have a better safety profile when compared to LSG.

Supplementary materials



Publication History

Received: 12 September 2019

Accepted: 23 January 2020

Article published online:
23 March 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 

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