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Efficacy of Endoscopic Interventions for the Management of Obesity: a Meta-analysis to Compare Endoscopic Sleeve Gastroplasty, AspireAssist, and Primary Obesity Surgery Endolumenal.

Efficacy of Endoscopic Interventions for the Management of Obesity: a Meta-analysis to Compare Endoscopic Sleeve Gastroplasty, AspireAssist, and Primary Obesity Surgery Endolumenal.

Obes Surg. 2019 Jul;29(7):2287-2298. doi: 10.1007/s11695-019-03865-w.
BACKGROUND AND AIMS:
Novel endoscopic procedures (endoscopic sleeve gastroplasty (ESG), AspireAssist (AA), and primary obesity surgery
endolumenal (POSE)) have been developed for treatment of obesity. We aimed to conduct a systematic review and metaanalysis
to evaluate and compare the efficacy of these three endoscopic procedures.


METHODS:
Main outcomes of interest were percent excess weight loss (%EWL) and percent total body weight loss (%TBWL). Weighted
pooled means (WPMs) were calculated and analyzed using random effects model. Mean differences (MDs) were calculated to
compare these procedures.
RESULTS:
Twelve studies with 1149 patients were included. WPMs for %EWL at 6 and 12 months with ESG were 49.67 (45.67, 53.66)
and 52.75 (43.52, 61.98), respectively, while %TBWLs at 6 and 12 months with ESG were 16.01 (15.10, 16.92) and 17.41
(17.08, 17.74), respectively. WPMs for %EWL at 6 and 12 months with POSE were 43.79 (40.17, 47.42) and 44.91 (40.90,
48.92), respectively. WPM for %EWL at 12 months with AA was 50.85 (46.03, 55.68). While comparing ESG and POSE, at
6 months and 12 months, MD for %EWL was 6.17 (1.07, 11.26; P = 0.01) and 7.84 (- 2.05, 17.71; P = 0.06) in favor of ESG.
No difference in %EWL was observed while comparing ESG with AA (P = 0.29). Likewise, MD for %EWL to compare AA and
POSE was not significant (P = 0.68).
CONCLUSIONS:
During a follow-up of 6-12 months, both AA and ESG had excellent efficacy in achieving significant and sustained weight loss;
however, ESG was found to be superior in terms of weight loss when compared with POSE.