Division of Gastroenterology, West Virginia University Health Sciences Center Charleston Division, Charleston, WV, USA.
Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Obes Surg. 2020 Aug;30(8):3010-3029. doi: 10.1007/s11695-020-04644-8.
We aimed to individually evaluate IGB and ESG procedures and compare the efficacy, durability, and safety of these procedures.
Bibliographic databases were systematically searched for studies investigating the use of IGB and ESG for the treatment of obesity. Studies reporting percent total weight loss (%TWL) or percent excess weight loss (%EWL) with at least 12 months of follow-up were included.
A total of 28 studies were included in the final analysis. Only 1 study directly compared ESG to IGB, 9 studies evaluated ESG alone, while 18 studies evaluated IGB. At 12-month follow-up after ESG, mean %TWL was 17.51 (95% CI 16.44-18.58), and %EWL was 60.51 (95% CI 54.39-66.64). Mean %TWL and %EWL after IGB at 12 months was 10.35 (95% CI 8.38-12.32) and 29.65 (95% CI 25.40-33.91), respectively. Mean %TWL and %EWL after IGB were significantly decreased at 18 or 24 months compared to 6 months indicating weight regain after IGB removal. ESG achieved significantly superior weight loss compared to IGB, the difference in mean %TWL was 7.33 (95% CI 5.22-9.44, p value = 0.0001) at 12 months. Serious adverse events were observed in < 5% for both procedures.
Although ESG and IGB are safe and effective for weight loss, our study suggests that ESG results in more significant and sustained weight loss. Nevertheless, a variety of approaches are essential to care for this underserved population, and there are several factors other than weight loss that should be considered in selecting the ideal therapy for individual patients.
我们旨在分别评估 IGB 和 ESG 手术，并比较这些手术的疗效、持久性和安全性。
系统地检索了评估 IGB 和 ESG 治疗肥胖的研究的文献数据库。纳入至少随访 12 个月且报告总体重减轻百分比（%TWL）或超重减轻百分比（%EWL）的研究。
共有 28 项研究纳入最终分析。仅有 1 项研究直接比较了 ESG 和 IGB，9 项研究单独评估了 ESG，而 18 项研究评估了 IGB。ESG 治疗后 12 个月的平均 %TWL 为 17.51（95%置信区间 16.44-18.58），%EWL 为 60.51（95%置信区间 54.39-66.64）。IGB 治疗后 12 个月的平均 %TWL 和 %EWL 分别为 10.35（95%置信区间 8.38-12.32）和 29.65（95%置信区间 25.40-33.91）。IGB 去除后 18 或 24 个月的平均 %TWL 和 %EWL 明显低于 6 个月，表明 IGB 去除后体重出现反弹。ESG 与 IGB 相比实现了显著更好的减重效果，12 个月时平均 %TWL 的差异为 7.33（95%置信区间 5.22-9.44，p 值=0.0001）。两种手术的严重不良事件发生率均低于 5%。
尽管 IGB 和 ESG 是安全有效的减肥方法，但我们的研究表明 ESG 可带来更显著和持久的减重效果。然而，为满足这一未满足需求的人群提供各种方法是至关重要的，并且在为个体患者选择理想的治疗方法时，除了减重之外，还有许多其他因素需要考虑。
