[Systematic review of endoscopic treatments for obesity: their safety and efficacy in weight reduction]

Obesity is a tremendous, increasing health problem worldwide. There are multiple endoscopic treatments for obesity. This study is a systematic review of researches on these methods and an evaluation of their safety and efficacy. We conducted a MEDLINE electronic research to review relevant English articles and abstracts published in the previous ten years [up to September 2012] on endoscopic treatments for human obesity. Overall, we found 62 articles. Of these, 42 articles [n=6406 cases] evaluated the bioenteric intragastric balloon [BIB] method. The percent of excess weight loss [EWL%] was 7.6%-62.3% and proportion of weight loss [WL] was 5.4-28.5 kg over six months. A total of five articles [n=159 cases] researched the air filled gastric balloon technique and reported a WL of approximately 10-17 kg in six months. Another five articles [n=112 cases] studied the duodeno jejuna bypass liner [DJBL] method and showed an EWL% of 11.9%-40% and WL of 8.2-16.7 kg over a 3-month period. Researchers evaluated botulinum toxin A [BTX A] injections in nine articles [n=144 cases] with a WL in two months of 0-11 kg. In three articles [n=64 cases], endoscopic suturing of the stomach was evaluated with an EWL% of 58.1 kg in six months. Another three articles [n=99 cases] evaluated transoral gastroplasty with an EWL% of 24.4%-36% and WL of 14-24 kg over six months. We have located numerous studies on the BIB procedure with lengthy [up to 5 years] monitoring of cases. According to these studies, BIB is a short-term, effective weight loss treatment. BIB may be a suitable method for preoperative weight loss in patients who are candidates for bariatric surgery to decrease the risk of surgery; in cases who are not candidates for surgery due to the risk of surgery; or in patients with moderate obesity as a primary weight loss treatment to induce changes in the patient's life style. DJBL and transoral gastroplasty sounds larger and more effects but additional longterm researches are needed to clarify the safety and efficacy of DJBL and transoral gastroplasty.