Abstract
Background and study aims Endoscopic sleeve gastroplasty (ESG) is a novel moderately invasive technique in endo-bariatrics
as compared to laparoscopic sleeve gastrectomy (LSG). Data is limited as to its efficacy
and safety.
Methods We searched multiple databases from inception through August 2019 to identify studies
that reported on ESG in the treatment of obesity. Our goals were to calculate the
pooled rates of total weight loss (%TWL), excess weight loss (%EWL), and body mass
index (BMI) at 1 month, 6 months, and 12 months with ESG. We included studies that
reported on LSG, in a similar time frame as ESG, and compared the 12-month outcomes.
Results From eight studies on ESG (1815 patients), the pooled rates of %TWL at 1 month, 6
months, and 12 months were 8.7 (7.2–10.2), 15.3 (14.1–16.6) and 17.1 (15.1–19.1),
respectively. The pooled rates of %EWL at 1 month, 6 months, and 12 months were 31.7
(29.3–34.1), 59.4 (57–61.8) and 63 (51.3–74.6), respectively. The pooled rates of
BMI at 1 m, 6 m, and 12 m were 32.6 (31–34.3), 30.4 (29–31.8) and 30 (27.7–32.3, I2 = 97), respectively. At 12 months, the pooled %TWL, %EWL and BMI with LSG (7 studies,
2179 patients) were 30.5 (27.4–33.5), 69.3 (60.1–78.4) and 29.3 (27.1–31.4) respectively.
On comparison analysis, %TWL with LSG was superior to ESG (P = 0.001). %EWL and BMI were comparable. All adverse events, bleeding and gastro-esophageal
reflux disease were significantly lower with ESG when compared to LSG.
Conclusion ESG demonstrates acceptable weight loss parameters and seems to have a better safety
profile when compared to LSG.
