Division of Gastroenterology, University of Toledo, Toledo, OH, USA.
Division of Gastroenterology, University of Alabama at Birmingham, Birmingham, AL, USA.
Obes Surg. 2019 Jul;29(7):2287-2298. doi: 10.1007/s11695-019-03865-w.
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 meta-analysis to evaluate and compare the efficacy of these three endoscopic procedures.
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.
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).
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.
新型内镜手术（内镜袖状胃成形术（ESG）、AspireAssist（AA）和原发性肥胖症内镜腔内手术（POSE））已被开发用于治疗肥胖症。我们旨在进行系统评价和荟萃分析，以评估和比较这三种内镜手术的疗效。
主要疗效指标为体重减轻百分比（%EWL）和总体重减轻百分比（%TBWL）。采用随机效应模型计算并分析加权平均值（WPM）。采用平均差值（MD）来比较这些程序。
共纳入 12 项研究，共 1149 例患者。ESG 术后 6 个月和 12 个月的 WPM 分别为 49.67（45.67，53.66）和 52.75（43.52，61.98），%TBWL 分别为 16.01（15.10，16.92）和 17.41（17.08，17.74）。POSE 术后 6 个月和 12 个月的 WPM 分别为 43.79（40.17，47.42）和 44.91（40.90，48.92）。AA 术后 12 个月的 WPM 为 50.85（46.03，55.68）。ESG 与 POSE 相比，6 个月和 12 个月时，%EWL 的 MD 分别为 6.17（1.07，11.26；P=0.01）和 7.84（-2.05，17.71；P=0.06），ESG 更优。ESG 与 AA 相比，%EWL 无差异（P=0.29）。同样，AA 与 POSE 之间的%EWL MD 无统计学意义（P=0.68）。
在 6-12 个月的随访期间，AA 和 ESG 在实现显著和持续减重方面均具有良好的疗效；然而，与 POSE 相比，ESG 在减重方面更具优势。
