Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis
| Autor: | Vivek Kumbhari, Jad Farha, Abdellah Hedjoudje, Mouen A. Khashab, Gontrand Lopez Nava, Anthony N. Kalloo, Manoel Galvao Neto, Aayed R. Alqahtani, Atif Adam, Javier Graus Morales, Zhixian Sui, Barham K. Abu Dayyeh, Lawrence J. Cheskin, Christopher C. Thompson, Dilhana Badurdeen, Adrian Sartoretto, Lea Fayad, Eric J. Vargas |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Gastroplasty Bariatric Surgery Cochrane Library Overweight law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Weight loss law Internal medicine Weight Loss medicine Humans Obesity Adverse effect Hepatology business.industry Gastroenterology medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Meta-analysis 030211 gastroenterology & hepatology Upper gastrointestinal bleeding medicine.symptom business Body mass index |
| Zdroj: | Clinical Gastroenterology and Hepatology. 18:1043-1053.e4 |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2019.08.022 |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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