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Systematic Review and Meta-Analysis of Endoscopic Sleeve Gastroplasty with Comparison to Laparoscopic Sleeve Gastrectomy

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Abstract

Purpose

Endoscopic sleeve gastroplasty (ESG) has grown in popularity as a potential minimally invasive bariatric procedure with acceptable short- and medium-term outcomes. This review aims to assess the safety and weight loss outcomes of ESG and compare it with laparoscopic sleeve gastrectomy (LSG).

Material and Methods

A comprehensive search of MEDLINE, EMBASE, Cochrane and World Wide Web was conducted.

Results

Five studies were reviewed, three ESG cohort studies and two case-matched cohort studies comparing ESG with LSG. Total unique ESG and LSG patients were 1451 and 203, respectively. All papers demonstrated a modest short-term total body weight loss (TBWL%) at 6 months ranging from 13.7 to 15.2% for ESG. Comparably, the two LSG papers demonstrated a superior TBWL% of 23.5 and 23.6% at 6 months, with one paper reporting a 12-month TBWL% of 29.3%. Two ESG papers reported medium-term results at 18 and 24 months of 14.8% and 18.6%, respectively. Excluding Clavien-Dindo 1 complications, ESG had a complication rate between 2.0 and 2.7%, while comparatively, LSG had a complication rate between 9.2 and 16.9% (current literature reported as 8.7%). In both procedures, there were no grade IV or V complications.

Conclusion

ESG when compared with LSG has lower short-term weight loss outcomes with fewer complications. Weight loss results for ESG appear to plateau after the 1-year mark. The future and uptake of ESG as a minimally invasive bariatric procedure will be determined by its long-term data on potential weight loss sustainability.

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References

  1. Moizé V, Andreu A, Flores L, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-en-Y gastric bypass in a Mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.

    Article  PubMed  Google Scholar 

  2. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, Prospective Trial. Obes Surg. 2012;22(5):740–8.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Abu Dayyeh BK et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol. 2017;15(1):37–43.e1.

    Article  PubMed  Google Scholar 

  5. Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012;31(1):219–30.

    Article  PubMed  Google Scholar 

  6. Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Jarolimova J, Tagoni J, Stern TA. Obesity: its epidemiology, comorbidities, and management. Prim Care Companion CNS Disord. 2013;15(5)

  8. The Look Ahead Research, G.C.-o.A. Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study. Obesity. 2014;22(1):5–13.

    Article  Google Scholar 

  9. Yanovski SZ, Yanovski JA. Long-term drug treatment for obesity: a systematic and clinical review. JAMA. 2014;311(1):74–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Sjöström L. Review of the key results from the Swedish obese subjects ( SOS ) trial – a prospective controlled intervention study of bariatric surgery. 2013:219–234.

  11. Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78(3):530–5.

    Article  PubMed  Google Scholar 

  12. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.

    Article  PubMed  Google Scholar 

  13. Alqahtani A, al-Darwish A, Mahmoud AE, et al. Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc. 2019;89(6):1132–8.

    Article  PubMed  Google Scholar 

  14. Sartoretto A, Sui Z, Hill C, et al. Endoscopic sleeve gastroplasty (ESG) is a reproducible and effective endoscopic bariatric therapy suitable for widespread clinical adoption: a large, International Multicenter Study. Obes Surg. 2018;28(7):1812–21.

    Article  PubMed  Google Scholar 

  15. Lopez-Nava G, Sharaiha RZ, Vargas EJ, et al. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg. 2017;27(10):2649–55.

    Article  PubMed  Google Scholar 

  16. Novikov AA et al. 334 - Endoscopic sleeve gastroplasty, laparoscopic sleeve gastroplasty, and laparoscopic band for weight loss, how do they compare? Gastroenterology. 2017;152(5):S1209.

    Article  Google Scholar 

  17. Fayad L et al. Tu1901 Weight outcomes of laparoscopic sleeve gastrectomy versus endoscopic sleeve gastroplasty: a case control study. Gastrointest Endosc. 2018;87(6):AB602.

    Article  Google Scholar 

  18. Dindo D, Demartines N, Clavien PA. Classification of surgical complications - a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Emile HS et al. Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech. 2017;27(5):307–17.

    Article  PubMed  Google Scholar 

  20. Kumar N. Gastric plication. Gastrointest Endosc Clin N Am. 2017;27(2):257–65.

    Article  PubMed  Google Scholar 

  21. Sharaiha RZ, Kumta NA, Saumoy M, et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol. 2017;15(4):504–10.

    Article  PubMed  Google Scholar 

  22. Anderson B, Switzer NJ, Almamar A, et al. The impact of laparoscopic sleeve gastrectomy on plasma ghrelin levels: a systematic review. Obes Surg. 2013;23(9):1476–80.

    Article  PubMed  Google Scholar 

  23. Pincock S. Peptide shows potential as an appetite suppressant. Lancet. 2003;362(9387):883.

    Article  Google Scholar 

  24. Saumoy M, Schneider Y, Zhou XK, et al. A single-operator learning curve analysis for the endoscopic sleeve gastroplasty. Gastrointest Endosc. 2018;87(2):442–7.

    Article  PubMed  Google Scholar 

  25. Hill C, et al. Endoscopic sleeve gastroplasty: the learning curve. 2017;5(9):E900–4.

  26. Courcoulas A et al. Intragastric balloon as an adjunct to lifestyle intervention: a randomized controlled trial. Int J Obes (2005). 2017;41(3):427–33.

    Article  CAS  Google Scholar 

  27. Ponce J, Woodman G, Swain J, et al. The REDUCE pivotal trial: a prospective, randomized controlled pivotal trial of a dual intragastric balloon for the treatment of obesity. Surg Obes Relat Dis. 2015;11(4):874–81.

    Article  PubMed  Google Scholar 

  28. Mehta A et al. 1106 – An analysis of leptin and insulin-glucose metabolism following endoscopic sleeve gastroplasty. Gastroenterology. 2019;156(6):S-236.

    Article  Google Scholar 

  29. Landreneau J, Strong AT, Rodriguez JH, et al. Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2018;28(12):3843–50.

    Article  PubMed  Google Scholar 

  30. Iannelli A, Debs T, Martini F, et al. Laparoscopic conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: indications and preliminary results. Surg Obes Relat Dis. 2016;12(8):1533–8.

    Article  PubMed  Google Scholar 

  31. Oor JE, Roks DJ, Ünlü Ç, et al. Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Surg. 2016;211(1):250–67.

    Article  PubMed  Google Scholar 

  32. Kumta NA, Doshi R, Aronne LJ, et al. Trimming the fat: endoscopic suturing for tightening of prior endoscopic sleeve gastroplasty. Gastrointest Endosc. 2017;85(1):253–4.

    Article  PubMed  Google Scholar 

  33. Alqahtani A, Elahmedi M, Alqahtani YA, et al. Laparoscopic sleeve gastrectomy after endoscopic sleeve gastroplasty: technical aspects and short-term outcomes. Obes Surg. 2019;29(11):3547–52.

    Article  PubMed  Google Scholar 

  34. Beitner M, Hopkins G. Conversion of endoscopic sleeve gastroplasty to laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2020;16:590–1.

    Article  PubMed  Google Scholar 

  35. Ferrer-Marquez M et al. Revision bariatric surgery after endoscopic sleeve gastroplasty. Cir Cir. 2017;85(5):428–31.

    PubMed  Google Scholar 

  36. Movitz BR, Lutfi RE. Endoscopic sleeve gastroplasty: are we burning bridges? Surg Obes Relat Dis. 2017;13(12):2056–8.

    Article  PubMed  Google Scholar 

  37. Cheng Q, Tree K, Devadas M. Is reversal of endoscopic sleeve gastroplasty and conversion to sleeve gastrectomy straight forward? A two case series. SPRINGER. 2019.

  38. Prevot F, Verhaeghe P, Pequignot A, et al. Two lessons from a 5-year follow-up study of laparoscopic sleeve gastrectomy: persistent, relevant weight loss and a short surgical learning curve. Surgery. 2014;155(2):292–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Blacktown Hospital, 14 Blacktown Rd, Blacktown, NSW, 2148, Australia

    Md Asif Jalal, Qiuye Cheng & Michael B. Edye

  2. Discipline of Surgery, University of Western Sydney, Sydney, Australia

    Md Asif Jalal, Qiuye Cheng & Michael B. Edye

Authors
  1. Md Asif Jalal
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  2. Qiuye Cheng
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Correspondence to Md Asif Jalal.

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Jalal, M.A., Cheng, Q. & Edye, M.B. Systematic Review and Meta-Analysis of Endoscopic Sleeve Gastroplasty with Comparison to Laparoscopic Sleeve Gastrectomy. OBES SURG 30, 2754–2762 (2020). https://doi.org/10.1007/s11695-020-04591-4

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  • DOI: https://doi.org/10.1007/s11695-020-04591-4

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