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Abstract：
BACKGROUND: Endoscopic sleeve gastroplasty (ESG) has gained momentum as a promising, minimally invasive bariatric therapy worldwide.
OBJECTIVE: We performed the first comprehensive systematic review and meta-analysis of studies to evaluate the efficacy, safety, and procedural technique of ESG.
METHODS: Bibliographic databases were systematically searched for studies assessing patients who underwent ESG for the treatment of obesity. Studies were included if they reported percent total weight loss or percent excess weight loss and the incidence of serious adverse events. Studies with <15 patients, follow-up period <6 months, and overlapping patients were excluded.
RESULTS: Eight observational studies with 1859 patients were included. Pooled mean percent total weight loss at 6, 12, and 24 months was 14.86 (95% confidence interval [CI]: 13.83-15.90), 16.43 (95%CI: 15.23-17.63), and 20.01 (95%CI: 16.92-23.11), respectively. Pooled mean percent excess weight loss at 6, 12, and 24 months was 55.75 (95%CI: 50.61-60.89), 61.84 (95%CI: 54.75-68.93), and 60.40 (95%CI: 48.88-71.92), respectively. The pooled incidence of serious adverse events was 2.26% (95%CI 1.25-4.03) and no mortality was reported. Gastrointestinal bleeding and perigastric fluid collection were the most common reported serious adverse events; however, the pooled incidence of both was <1%. Variations in procedural technique were seen, but the full-thickness nature of suturing was reported in all studies. A layer of reinforcement sutures was performed in the majority of studies (n = 6). Limitations include the lack of controlled studies, long-term follow-up data, and standardization of technique.
CONCLUSIONS: ESG, a minimally invasive bariatric therapy, is reproducible among centers worldwide with effective weight loss and favorable safety profile outcomes. Controlled studies would be valuable to further corroborate these findings.
OBJECTIVE: We performed the first comprehensive systematic review and meta-analysis of studies to evaluate the efficacy, safety, and procedural technique of ESG.
METHODS: Bibliographic databases were systematically searched for studies assessing patients who underwent ESG for the treatment of obesity. Studies were included if they reported percent total weight loss or percent excess weight loss and the incidence of serious adverse events. Studies with <15 patients, follow-up period <6 months, and overlapping patients were excluded.
RESULTS: Eight observational studies with 1859 patients were included. Pooled mean percent total weight loss at 6, 12, and 24 months was 14.86 (95% confidence interval [CI]: 13.83-15.90), 16.43 (95%CI: 15.23-17.63), and 20.01 (95%CI: 16.92-23.11), respectively. Pooled mean percent excess weight loss at 6, 12, and 24 months was 55.75 (95%CI: 50.61-60.89), 61.84 (95%CI: 54.75-68.93), and 60.40 (95%CI: 48.88-71.92), respectively. The pooled incidence of serious adverse events was 2.26% (95%CI 1.25-4.03) and no mortality was reported. Gastrointestinal bleeding and perigastric fluid collection were the most common reported serious adverse events; however, the pooled incidence of both was <1%. Variations in procedural technique were seen, but the full-thickness nature of suturing was reported in all studies. A layer of reinforcement sutures was performed in the majority of studies (n = 6). Limitations include the lack of controlled studies, long-term follow-up data, and standardization of technique.
CONCLUSIONS: ESG, a minimally invasive bariatric therapy, is reproducible among centers worldwide with effective weight loss and favorable safety profile outcomes. Controlled studies would be valuable to further corroborate these findings.
摘要：
背景：内镜套管胃成形术（ESG）已经获得了有希望的势头，全球微创减肥治疗。
目的：我们对研究进行了首次全面的系统评价和荟萃分析，以评估疗效，安全,和ESG的程序化技术。
方法：系统搜索文献数据库，以评估接受ESG治疗肥胖患者的研究。如果研究报告了总体重减轻百分比或过量体重减轻百分比以及严重不良事件的发生率，则将其包括在内。对<15名患者的研究，随访期<6个月，重叠患者被排除.
结果：纳入了8项观察性研究，共1859例患者。6、12和24个月的总体重减轻的平均百分比为14.86（95％置信区间[CI]：13.83-15.90），16.43（95CI：15.23-17.63），和20.01（95CI：16.92-23.11），分别。6个月、12个月和24个月的总平均多余体重减轻百分比为55.75（95CI：50.61-60.89），61.84（95CI：54.75-68.93），和60.40（95CI：48.88-71.92），分别。严重不良事件的合并发生率为2.26%（95CI1.25-4.03），无死亡报告。胃肠道出血和胃周积液是最常见的严重不良事件；然而，两者的合并发生率均<1%.观察到程序技术的变化，但所有研究都报道了全层缝合的性质.在大多数研究中（n=6）进行了一层加固缝线。局限性包括缺乏对照研究，长期随访数据，技术的标准化。
结论：ESG，一种微创减肥疗法,在全球中心中具有可复制性，具有有效的体重减轻和良好的安全性结果。对照研究对于进一步证实这些发现将是有价值的。
目的：我们对研究进行了首次全面的系统评价和荟萃分析，以评估疗效，安全,和ESG的程序化技术。
方法：系统搜索文献数据库，以评估接受ESG治疗肥胖患者的研究。如果研究报告了总体重减轻百分比或过量体重减轻百分比以及严重不良事件的发生率，则将其包括在内。对<15名患者的研究，随访期<6个月，重叠患者被排除.
结果：纳入了8项观察性研究，共1859例患者。6、12和24个月的总体重减轻的平均百分比为14.86（95％置信区间[CI]：13.83-15.90），16.43（95CI：15.23-17.63），和20.01（95CI：16.92-23.11），分别。6个月、12个月和24个月的总平均多余体重减轻百分比为55.75（95CI：50.61-60.89），61.84（95CI：54.75-68.93），和60.40（95CI：48.88-71.92），分别。严重不良事件的合并发生率为2.26%（95CI1.25-4.03），无死亡报告。胃肠道出血和胃周积液是最常见的严重不良事件；然而，两者的合并发生率均<1%.观察到程序技术的变化，但所有研究都报道了全层缝合的性质.在大多数研究中（n=6）进行了一层加固缝线。局限性包括缺乏对照研究，长期随访数据，技术的标准化。
结论：ESG，一种微创减肥疗法,在全球中心中具有可复制性，具有有效的体重减轻和良好的安全性结果。对照研究对于进一步证实这些发现将是有价值的。
