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

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

Clin Gastroenterol Hepatol. 2019 Aug 20.
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:
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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.