Comparative efficacy of bariatric endoscopic procedures in the treatment of morbid obesity: a systematic review and network meta-analysis.
Endoscopy
; 52(11): 940-954, 2020 11.
Article
en En
| MEDLINE
| ID: mdl-32325513
ABSTRACT
BACKGROUND:
The comparative efficacy of bariatric endoscopic procedures has not been completely elucidated. We aimed to comprehensively evaluate the efficacy of bariatric endoscopic procedures.METHODS:
We searched for randomized controlled trials investigating the efficacy of bariatric endoscopic procedures, including the use of an intragastric balloon, duodenal-jejunal bypass liner (DJBL), aspiration therapy, primary obesity surgery endoluminal (POSE) procedure, and botulinum toxin injection to the stomach. Network meta-analyses were performed to determine the percentage of weight loss (%weight loss) and percentage of excess weight loss (%EWL).RESULTS:
22 studies with 2141 patients were included in the meta-analysis. Most endoscopic procedures showed superior efficacy in terms of %weight loss compared with the control (mean difference [MD] [95â% confidence interval (CI)] aspiration therapy 10.4â% [7.0â% to 13.7â%]; fluid-filled balloon 5.3â% [3.4â% to 7.2â%]; POSE 4.9â% [1.7â% to 8.2â%]; and DJBL 4.5â% [1.4â% to 7.7â%]). In terms of %EWL, aspiration therapy, fluid-filled balloon, POSE, and DJBL were superior to the control (MD [95â%CI] 27.3â% [15.3â% to 39.3â%]; 22.4â% [15.4â% to 29.4â%]; 15.3â% [2.5â% to 28.0â%]; and 13.0â% [4.9â% to 21.2], respectively). The gas-filled balloon and botulinum toxin injection did not show a significant difference in %weight loss or %EWL compared with the control. For the fluid-filled balloon, the %EWL and %weight loss tended to decrease after balloon removal at 6 months after the procedure.CONCLUSION:
All bariatric endoscopic procedures, except for gas-filled balloon and botulinum toxin injection to the stomach, showed superior short-term efficacy in terms of %weight loss or %EWL compared with lifestyle modification.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Obesidad Mórbida
/
Balón Gástrico
/
Cirugía Bariátrica
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Endoscopy
Año:
2020
Tipo del documento:
Article