Skip to main content
Top
Published in: Surgical Endoscopy 3/2020

01-03-2020 | Obesity

Efficacy and safety of endoscopic sleeve gastroplasty for obesity patients: a meta-analysis

Authors: Peiwen Li, Bin Ma, Shulei Gong, Xinyu Zhang, Wenya Li

Published in: Surgical Endoscopy | Issue 3/2020

Login to get access

Abstract

Background

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, effective, and safe technique for weight loss intervention. Since a relatively small number of cases were present in previous studies, this study aimed to elucidate the efficacy and safety of ESG.

Methods

Relevant publications were identified through searching PubMed, EMBASE, Cochrane, and Web of Science before March 1, 2019. The percentage of total body weight loss (%TBWL), percentage of excess weight loss (%EWL), and the adverse event rate in each follow-up session were extracted, pooled, and analyzed. Forest plots were graphed based on random effects models.

Results

A total of 1542 patients from nine studies were eligible for analysis. The pooled results of %TBWL at 1, 3, 6, and 12 months were 8.78% (p = 0.000), 11.85% (p = 0.000), 14.47% (p = 0.024), and 16.09% (p = 0.063), respectively. The pooled results of %EWL at 1, 3, 6, and 12 months were 31.16% (p = 0.000), 43.61% (p = 0.000), 53.14% (p = 0.000), and 59.08% (p = 0.015), respectively. Finally, the pooled rate of mild adverse events was 72% (p < 0.01), and the pooled estimate of severe adverse events was only 1% (p = 0.08).

Conclusion

Although the conventional surgical sleeve gastrectomy is the gold standard for bariatric surgery, ESG could be a promising minimally invasive alternative for treating obesity with satisfactory efficacy and low risk.
Literature
1.
go back to reference Bray GA, Kim KK, Wilding JPH, World Obesity F (2017) Obesity: a chronic relapsing progressive disease process: a position statement of the World Obesity Federation. Obes Rev 18:715–723CrossRef Bray GA, Kim KK, Wilding JPH, World Obesity F (2017) Obesity: a chronic relapsing progressive disease process: a position statement of the World Obesity Federation. Obes Rev 18:715–723CrossRef
2.
go back to reference Hiatt WR, Thomas A, Goldfine AB (2012) What cost weight loss? Circulation 125:1171–1177CrossRef Hiatt WR, Thomas A, Goldfine AB (2012) What cost weight loss? Circulation 125:1171–1177CrossRef
3.
go back to reference Middleton KM, Patidar SM, Perri MG (2012) The impact of extended care on the long-term maintenance of weight loss: a systematic review and meta-analysis. Obes Rev 13:509–517CrossRef Middleton KM, Patidar SM, Perri MG (2012) The impact of extended care on the long-term maintenance of weight loss: a systematic review and meta-analysis. Obes Rev 13:509–517CrossRef
4.
go back to reference Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ES, Nissen SE, Kashyap SR (2014) Bariatric surgery versus intensive medical therapy for diabetes: 3-year outcomes. N Engl J Med 370:2002–2013CrossRef Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ES, Nissen SE, Kashyap SR (2014) Bariatric surgery versus intensive medical therapy for diabetes: 3-year outcomes. N Engl J Med 370:2002–2013CrossRef
5.
go back to reference Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, Heinberg LJ, Kushner R, Adams TD, Shikora S, Dixon JB, Brethauer S (2013) Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient–2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity 21(Suppl 1):S1–27CrossRef Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, Heinberg LJ, Kushner R, Adams TD, Shikora S, Dixon JB, Brethauer S (2013) Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient–2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity 21(Suppl 1):S1–27CrossRef
6.
go back to reference Abu Dayyeh BK, Kumar N, Edmundowicz SA, Jonnalagadda S, Larsen M, Sullivan S, Thompson CC, Banerjee S (2015) ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc 82:425–438.e425CrossRef Abu Dayyeh BK, Kumar N, Edmundowicz SA, Jonnalagadda S, Larsen M, Sullivan S, Thompson CC, Banerjee S (2015) ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc 82:425–438.e425CrossRef
7.
go back to reference Hill C, Khashab MA, Kalloo AN, Kumbhari V (2018) Endoluminal weight loss and metabolic therapies: current and future techniques. Ann N Y Acad Sci 1411:36–52CrossRef Hill C, Khashab MA, Kalloo AN, Kumbhari V (2018) Endoluminal weight loss and metabolic therapies: current and future techniques. Ann N Y Acad Sci 1411:36–52CrossRef
8.
go back to reference Kumbhari V, Hill C, Sullivan S (2017) Bariatric endoscopy: state-of-the-art. Curr Opin Gastroenterol 33:358–365CrossRef Kumbhari V, Hill C, Sullivan S (2017) Bariatric endoscopy: state-of-the-art. Curr Opin Gastroenterol 33:358–365CrossRef
9.
go back to reference Yorke E, Switzer NJ, Reso A, Shi X, de Gara C, Birch D, Gill R, Karmali S (2016) Intragastric balloon for management of severe obesity: a systematic review. Obes Surg 26:2248–2254CrossRef Yorke E, Switzer NJ, Reso A, Shi X, de Gara C, Birch D, Gill R, Karmali S (2016) Intragastric balloon for management of severe obesity: a systematic review. Obes Surg 26:2248–2254CrossRef
10.
go back to reference Rohde U, Hedback N, Gluud LL, Vilsboll T, Knop FK (2016) Effect of the EndoBarrier gastrointestinal Liner ON obesity and type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab 18:300–305CrossRef Rohde U, Hedback N, Gluud LL, Vilsboll T, Knop FK (2016) Effect of the EndoBarrier gastrointestinal Liner ON obesity and type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab 18:300–305CrossRef
11.
go back to reference Abu Dayyeh BK, Rajan E, Gostout CJ (2013) Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc 78:530–535CrossRef Abu Dayyeh BK, Rajan E, Gostout CJ (2013) Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc 78:530–535CrossRef
12.
go back to reference Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605CrossRef Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605CrossRef
13.
go back to reference Ginsberg GG, Chand B, Cote GA, Dallal RM, Edmundowicz SA, Nguyen NT, Pryor A, Thompson CC (2011) A pathway to endoscopic bariatric therapies. Gastrointest Endosc 74:943–953CrossRef Ginsberg GG, Chand B, Cote GA, Dallal RM, Edmundowicz SA, Nguyen NT, Pryor A, Thompson CC (2011) A pathway to endoscopic bariatric therapies. Gastrointest Endosc 74:943–953CrossRef
14.
go back to reference Lopez-Nava G, Galvao MP, Bautista-Castano I, Jimenez-Banos A, Fernandez-Corbelle JP (2015) Endoscopic sleeve gastroplasty: how I do it? Obes Surg 25:1534–1538CrossRef Lopez-Nava G, Galvao MP, Bautista-Castano I, Jimenez-Banos A, Fernandez-Corbelle JP (2015) Endoscopic sleeve gastroplasty: how I do it? Obes Surg 25:1534–1538CrossRef
15.
go back to reference Lopez-Nava G, Galvao MP, da Bautista-Castano I, Jimenez A, De Grado T, Fernandez-Corbelle JP (2015) Endoscopic sleeve gastroplasty for the treatment of obesity. Endoscopy 47:449–452CrossRef Lopez-Nava G, Galvao MP, da Bautista-Castano I, Jimenez A, De Grado T, Fernandez-Corbelle JP (2015) Endoscopic sleeve gastroplasty for the treatment of obesity. Endoscopy 47:449–452CrossRef
16.
go back to reference Lopez-Nava Breviere G, Bautista-Castano I, Fernandez-Corbelle JP, Trell M (2016) Endoscopic sleeve gastroplasty (the Apollo method): a new approach to obesity management. Rev Esp Enferm Dig 108:201–206CrossRef Lopez-Nava Breviere G, Bautista-Castano I, Fernandez-Corbelle JP, Trell M (2016) Endoscopic sleeve gastroplasty (the Apollo method): a new approach to obesity management. Rev Esp Enferm Dig 108:201–206CrossRef
17.
go back to reference Lopez-Nava G, Galvao MP, Bautista-Castano I, Fernandez-Corbelle JP, Trell M, Lopez N (2017) Endoscopic sleeve gastroplasty for obesity treatment: two years of experience. Arq Bras Cir Dig 30:18–20CrossRef Lopez-Nava G, Galvao MP, Bautista-Castano I, Fernandez-Corbelle JP, Trell M, Lopez N (2017) Endoscopic sleeve gastroplasty for obesity treatment: two years of experience. Arq Bras Cir Dig 30:18–20CrossRef
18.
go back to reference Lopez-Nava G, Sharaiha RZ, Vargas EJ, Bazerbachi F, Manoel GN, Bautista-Castano I, Acosta A, Topazian MD, Mundi MS, Kumta N, Kahaleh M, Herr AM, Shukla A, Aronne L, Gostout CJ, Abu Dayyeh BK (2017) Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg 27:2649–2655CrossRef Lopez-Nava G, Sharaiha RZ, Vargas EJ, Bazerbachi F, Manoel GN, Bautista-Castano I, Acosta A, Topazian MD, Mundi MS, Kumta N, Kahaleh M, Herr AM, Shukla A, Aronne L, Gostout CJ, Abu Dayyeh BK (2017) Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg 27:2649–2655CrossRef
19.
go back to reference Abu Dayyeh BK, Acosta A, Camilleri M, Mundi MS, Rajan E, Topazian MD, Gostout CJ (2017) Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol 15(37–43):e31 Abu Dayyeh BK, Acosta A, Camilleri M, Mundi MS, Rajan E, Topazian MD, Gostout CJ (2017) Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol 15(37–43):e31
20.
go back to reference Sharaiha RZ, Kumta NA, Saumoy M, Desai AP, Sarkisian AM, Benevenuto A, Tyberg A, Kumar R, Igel L, Verna EC, Schwartz R, Frissora C, Shukla A, Aronne LJ, Kahaleh M (2017) Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol 15:504–510CrossRef Sharaiha RZ, Kumta NA, Saumoy M, Desai AP, Sarkisian AM, Benevenuto A, Tyberg A, Kumar R, Igel L, Verna EC, Schwartz R, Frissora C, Shukla A, Aronne LJ, Kahaleh M (2017) Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol 15:504–510CrossRef
21.
go back to reference Novikov AA, Afaneh C, Saumoy M, Parra V, Shukla A, Dakin GF, Pomp A, Dawod E, Shah S, Aronne LJ, Sharaiha RZ (2017) Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic band for weight loss: how do they compare? J Gastrointest Surg 22:267–273CrossRef Novikov AA, Afaneh C, Saumoy M, Parra V, Shukla A, Dakin GF, Pomp A, Dawod E, Shah S, Aronne LJ, Sharaiha RZ (2017) Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic band for weight loss: how do they compare? J Gastrointest Surg 22:267–273CrossRef
22.
go back to reference Alqahtani A, Al-Darwish A, Mahmoud AE, Alqahtani YA, Elahmedi M (2018) Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc 89(6):1132–1138CrossRef Alqahtani A, Al-Darwish A, Mahmoud AE, Alqahtani YA, Elahmedi M (2018) Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc 89(6):1132–1138CrossRef
23.
go back to reference Fayad L, Adam A, Schweitzer M, Cheskin LJ, Ajayi T, Dunlap M, Badurdeen DS, Hill C, Paranji N, Lalezari S, Kalloo AN, Khashab MA, Kumbhari V (2018) Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc 89(4):782–788CrossRef Fayad L, Adam A, Schweitzer M, Cheskin LJ, Ajayi T, Dunlap M, Badurdeen DS, Hill C, Paranji N, Lalezari S, Kalloo AN, Khashab MA, Kumbhari V (2018) Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc 89(4):782–788CrossRef
24.
go back to reference Sartoretto A, Sui Z, Hill C, Dunlap M, Rivera AR, Khashab MA, Kalloo AN, Fayad L, Cheskin LJ, Marinos G, Wilson E, Kumbhari V (2018) Endoscopic sleeve gastroplasty (ESG) is a reproducible and effective endoscopic bariatric therapy suitable for widespread clinical adoption: a large, international multicenter study. Obes Surg 28:1812–1821CrossRef Sartoretto A, Sui Z, Hill C, Dunlap M, Rivera AR, Khashab MA, Kalloo AN, Fayad L, Cheskin LJ, Marinos G, Wilson E, Kumbhari V (2018) Endoscopic sleeve gastroplasty (ESG) is a reproducible and effective endoscopic bariatric therapy suitable for widespread clinical adoption: a large, international multicenter study. Obes Surg 28:1812–1821CrossRef
25.
go back to reference Saumoy M, Schneider Y, Zhou XK, Shukla A, Kahaleh M, Aronne L, Sharaiha RZ (2018) A single-operator learning curve analysis for the endoscopic sleeve gastroplasty. Gastrointest Endosc 87:442–447CrossRef Saumoy M, Schneider Y, Zhou XK, Shukla A, Kahaleh M, Aronne L, Sharaiha RZ (2018) A single-operator learning curve analysis for the endoscopic sleeve gastroplasty. Gastrointest Endosc 87:442–447CrossRef
26.
go back to reference Imaz I, Martinez-Cervell C, Garcia-Alvarez EE, Sendra-Gutierrez JM, Gonzalez-Enriquez J (2008) Safety and effectiveness of the intragastric balloon for obesity: a meta-analysis. Obes Surg 18:841–846CrossRef Imaz I, Martinez-Cervell C, Garcia-Alvarez EE, Sendra-Gutierrez JM, Gonzalez-Enriquez J (2008) Safety and effectiveness of the intragastric balloon for obesity: a meta-analysis. Obes Surg 18:841–846CrossRef
27.
go back to reference Gaur S, Levy S, Mathus-Vliegen L, Chuttani R (2015) Balancing risk and reward: a critical review of the intragastric balloon for weight loss. Gastrointest Endosc 81:1330–1336CrossRef Gaur S, Levy S, Mathus-Vliegen L, Chuttani R (2015) Balancing risk and reward: a critical review of the intragastric balloon for weight loss. Gastrointest Endosc 81:1330–1336CrossRef
28.
go back to reference Moura D, Oliveira J, De Moura EG, Bernardo W, Galvao Neto M, Campos J, Popov VB, Thompson C (2016) Effectiveness of intragastric balloon for obesity: a systematic review and meta-analysis based on randomized control trials. Surg Obes Relat Dis 12:420–429CrossRef Moura D, Oliveira J, De Moura EG, Bernardo W, Galvao Neto M, Campos J, Popov VB, Thompson C (2016) Effectiveness of intragastric balloon for obesity: a systematic review and meta-analysis based on randomized control trials. Surg Obes Relat Dis 12:420–429CrossRef
29.
go back to reference Kim SH, Chun HJ, Choi HS, Kim ES, Keum B, Jeen YT (2016) Current status of intragastric balloon for obesity treatment. World J Gastroenterol 22:5495–5504CrossRef Kim SH, Chun HJ, Choi HS, Kim ES, Keum B, Jeen YT (2016) Current status of intragastric balloon for obesity treatment. World J Gastroenterol 22:5495–5504CrossRef
Metadata
Title
Efficacy and safety of endoscopic sleeve gastroplasty for obesity patients: a meta-analysis
Authors
Peiwen Li
Bin Ma
Shulei Gong
Xinyu Zhang
Wenya Li
Publication date
01-03-2020
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 3/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-06889-6

Other articles of this Issue 3/2020

Surgical Endoscopy 3/2020 Go to the issue