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Comparison Between Laparoscopic Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication Treatments for Obesity: an Updated Systematic Review and Meta-Analysis

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Abstract

Bariatric surgery has been widely performed to treat morbid obesity. Our meta-analysis aims to provide an updated comparison between laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curvature plication (LGCP). Medline, EMBASE, Scopus, and Cochrane Central were searched. Ongoing clinical trials were identified from the clinicaltrials.gov website. References of the chosen literatures were manually reviewed for additional relevant studies. As a result, a total of 18 studies involving 1329 patients were selected. We demonstrated a significant higher excess weight loss (%EWL) after LSG at the 1-, 3-, 6-, 12-, and 18-month follow-up time points. However, no significant difference was found at 36 months. Body Mass Index Loss (BMIL) was better after LSG than LGCP at 12 and 24 months. The difference in the improvement of comorbidities (i.e., T2-DM, hypertension, and sleep apnea) did not reach statistical significance. The complications (i.e., bleeding, stenosis, leak, and abdominal pain), operative time, and length of hospital stay were comparable. More patients undergoing LGCP experienced nausea and vomiting. We obtained some different and new results compared to the previously published meta-analysis. Our meta-analysis showed significantly higher %EWL at 24 months (Z=2.08, p=0.04), significantly higher BMIL at 36 months (Z=9.11, p <0.00001), and significantly higher costs (Z=2.87, p=0.004) in the LSG group. In addition, for the first time, complications (i.e., GERD, wound infection, port-site hernia, and mortality) and improvement of dyslipidemia were compared between the two techniques. According to our pooled data, no significant differences were found in any of the above aspects. In conclusion, LSG is superior to LGCP with regard to providing effective weight loss in the short- and mid-term. LSG has a lower rate of minor complications, but was less effective when considering cost. The two procedures are similar in terms of improvement of comorbidities, major complications, operative time, and length of stay.

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References

  1. Schachter J, Martel J, Lin CS, et al. Effects of obesity on depression: a role for inflammation and the gut microbiota. Brain Behav Immun. 2018;69(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  2. Wu YK, Berry DC. Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: a systematic review. J Adv Nurs. 2017;74(5):1030–42.

    Article  PubMed  Google Scholar 

  3. Smith KB, Smith MS. Obesity statistics. Prim Care. 2016;43:121–35.

    Article  PubMed  Google Scholar 

  4. Azagury D, Papasavas P, Hamdallah I, et al. ASMBS Position Statement on medium- and long-term durability of weight loss and diabetic outcomes after conventional stapled bariatric procedures. Surg Obes Relat Dis. 2018;14:1425–41.

    Article  PubMed  Google Scholar 

  5. Carrano FM, Peev MP, Saunders JK, et al. The role of minimally invasive and endoscopic technologies in morbid obesity treatment: review and critical appraisal of the current clinical practice. Obes Surg. 2020;30:736–52.

    Article  PubMed  Google Scholar 

  6. Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.

    Article  PubMed  Google Scholar 

  7. Kueper MA, Kramer KM, Kirschniak A, et al. Laparoscopic sleeve gastrectomy: standardized technique of a potential stand-alone bariatric procedure in morbidly obese patients. World J Surg. 2008;32(7):1462–5.

    Article  PubMed  Google Scholar 

  8. Khidir N, Al DM, El AW, et al. Outcomes of laparoscopic gastric greater curvature plication in morbidly obese patients. J Obes. 2017:1–6.

  9. Doležalova-Kormanova K, Buchwald JN, Skochova D, et al. Five-year outcomes: laparoscopic greater curvature plication for treatment of morbid obesity. Obes Surg. 2017;27(11):2818–28.

    Article  PubMed  Google Scholar 

  10. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1-190–215-357. iii-iv

    Article  Google Scholar 

  11. Zerrweck C, Rodriguez JG, Aramburo E, et al. Revisional surgery following laparoscopic gastric plication. Obes Surg. 2017;27(1):38–43.

    Article  PubMed  Google Scholar 

  12. Perivoliotis K, Sioka E, Katsogridaki G, et al. Laparoscopic gastric plication versus laparoscopic sleeve gastrectomy: an up-to-date systematic review and meta-analysis. J Obes. 2018;3617458

  13. Suarez DF, Gangemi A. How bad is “bad”? A cost consideration and review of laparoscopic gastric plication versus laparoscopic sleeve gastrectomy. Obes Surg. 2021;31(1):307–16.

    Article  PubMed  Google Scholar 

  14. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoSMedicine. 2009;6(7):e1000097.

    Google Scholar 

  15. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.

    Article  CAS  PubMed  Google Scholar 

  17. Wells G (2014) The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomised studies in meta-analyses. Symposium on Systematic Reviews: Beyond the Basics

  18. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Lopeznava G, Asokkumar R, Bautista I et al. Endoscopic Sleeve Gastroplasty (ESG), Laparoscopic Sleeve Gastrectomy (LSG), and Laparoscopic Greater Curve Plication (LGCP): Do They Differ at 2-years?. Endoscopy 2020. https://doi.org/10.1055/a-1224-7231

  20. Neagoe RM, Timofte D, Mureşan M, et al. Laparoscopic gastric plication vs laparoscopic sleeve gastrectomy - a single center, prospective and case-control study. Chirurgia (Bucur). 2019;114:769–78.

    Article  Google Scholar 

  21. Li YH, Wang BY, Huang YC, et al. Clinical outcomes of laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy: a case-matched control study. Obes Surg. 2019;29:387–93.

    Article  PubMed  Google Scholar 

  22. Talebpour M, Sadid D, Talebpour A, et al. Comparison of short-term effectiveness and postoperative complications: laparoscopic gastric plication vs laparoscopic sleeve gastrectomy. Obes Surg. 2018;28:996–1001.

    Article  PubMed  Google Scholar 

  23. Nabil TM, Moustafa KG, Balamoun HA (2018) Comparison of laparoscopic sleeve gastrectomy and laparoscopic gastric plication: two-year follow-up results. Bariatric Surgical Patient Care

  24. Casajoana A, Pujol J, Garcia A, et al. Predictive value of gut peptides in T2D remission: randomized controlled trial comparing metabolic gastric bypass, sleeve gastrectomy and greater curvature plication. Obes Surg. 2017;27:2235–45.

    Article  PubMed  Google Scholar 

  25. Bužga M, Švagera Z, Tomášková H, et al. Metabolic effects of sleeve gastrectomy and laparoscopic greater curvature plication: an 18-month prospective, observational, open-label study. Obes Surg. 2017;27:3258–66.

    Article  PubMed  Google Scholar 

  26. Park YH, Kim SM. Short-term outcomes of laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy in patients with a body mass index of 30 to 35 kg/m2. Yonsei Med J. 2017;58:1025–30.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Grubnik VV, Ospanov OB, Namaeva KA, et al. Randomized controlled trial comparing laparoscopic greater curvature plication versus laparoscopic sleeve gastrectomy. Surg Endosc. 2016;30:2186–91.

    Article  CAS  PubMed  Google Scholar 

  28. Toprak SS, Gültekin Y, Okuş A. Comparison of laparoscopic sleeve gastrectomy and laparoscopic gastric plication: one year follow-up results. Ulus Cerrahi Derg. 2016;32:18–22.

    PubMed  Google Scholar 

  29. Chouillard E, Schoucair N, Alsabah S, et al. Laparoscopic gastric plication (LGP) as an alternative to laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity: a preliminary, short-term, case-control study. Obes Surg. 2016;26:1167–72.

    Article  PubMed  Google Scholar 

  30. Abdelnazer NA, Daoud EA, Sharouda SM. Laparoscopic gastric plication versus laparoscopic sleeve gastrectomy as a surgical treatment of morbid obesity. Life Science Journal. 2016;13(1)

  31. Verdi D, Prevedello L, Albanese A, et al. Laparoscopic gastric plication (LGCP) vs sleeve gastrectomy (LSG): a single institution experience. Obes Surg. 2015;25:1653–7.

    Article  PubMed  Google Scholar 

  32. Abouzeid M, Taha O. Laparoscopic sleeve gastrectomy versus laparoscopic gastric greater curvature plication: a prospective randomized comparative study. Egyptian Journal of Surgery. 2015;34(1)

  33. Sharma S, Narwaria M, Cottam DR, et al. Randomized double-blinded trial of laparoscopic gastric imbrication vs laparoscopic sleeve gastrectomy at a single Indian institution. Obes Surg. 2014;25(5):1–5.

    Google Scholar 

  34. Abdelbaki TN, Sharaan M, Abdel-Baki NA, et al. Laparoscopic gastric greater curvature plication versus laparoscopic sleeve gastrectomy: early outcome in 140 patients. Surg Obes Relat Dis. 2014;10:1141–6.

    Article  PubMed  Google Scholar 

  35. Shen D, Ye H, Wang Y, et al. Comparison of short-term outcomes between laparoscopic greater curvature plication and laparoscopic sleeve gastrectomy. Surg Endosc. 2013;27:2768–74.

    Article  PubMed  Google Scholar 

  36. Morshed G, Abdalla H. Laparoscopic gastric plication versus laparoscopic sleeve gastrectomy. Med J Cairo Univ. 2011;79(4)

  37. Alexandrou A, Athanasiou A, Michalinos A, et al. Laparoscopic sleeve gastrectomy for morbid obesity: 5-year results. Am J Surg. 2015;209(2):230–4.

    Article  PubMed  Google Scholar 

  38. Golomb I, Ben DM, Glass A, et al. Long-term metabolic effects of laparoscopic sleeve gastrectomy. JAMA Surg. 2015;150(11):1051–7.

    Article  PubMed  Google Scholar 

  39. Varela JE, Nguyen NT. Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers. Surg Obes Relat Dis. 2015;11(5):987–90.

    Article  PubMed  Google Scholar 

  40. Coblijn UK, Karres J, Raaff CALD, et al. Predicting postoperative complications after bariatric surgery: the Bariatric Surgery Index for Complications, BASIC. Surgical Endoscopy. 2017;31(11):4438–45.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Silecchia G, Iossa A. Complications of staple line and anastomoses following laparoscopic bariatric surgery. Ann Gastroenterol. 2017;31(1):56–64.

    PubMed  PubMed Central  Google Scholar 

  42. Lapatsanis D, Sidirokastritis G, Kontaxis V, et al. Laparoscopic total vertical gastric plication (LTVGP) and laparoscopic sleeve gastrectomy (LSG) as restrictive bariatric procedures. Results, comparison, cost effectiveness differences and similarities. Obes Surg. 2011;21:1010.

    Google Scholar 

  43. Ospanov OB, Sultanov EE. Laparoscopic sleeve gastroplication versus laparoscopic sleeve gastrectomy: preliminary results. Surg Endosc Interven Tech. 2013;27:S132.

    Google Scholar 

  44. Fardoun A. Gastric plication versus sleeve: 700 cases none randomized study. Obes Surg. 2014;24:1016–7.

    Google Scholar 

  45. Cesana G, Uccelli M, Ciccarese F, et al. Laparoscopic gastric plication versus sleeve gastrectomy, a randomized study. Obes Surg. 2013;23:1024–5.

    Google Scholar 

  46. Abou AHS, Zeineldin AA, Al KAF. Comparative study between laparoscopic sleeve gastrectomy and laparoscopic gastric plication: early results. Obes Surg. 2014;24:1139–40.

    Google Scholar 

  47. Ciemy M, Ciemy M, Kriz M, et al. Gastric plication versus gastric sleeve-a single center short-term comparison. Obes Surg. 2013;23:1024.

    Google Scholar 

  48. Cummings DE. Ghrelin and the short- and long-term regulation of appetite and body weight. Physiol Behav. 2006;89:71–84.

    Article  CAS  PubMed  Google Scholar 

  49. Kirchner H, Heppner KM, Tschop MH. The role of ghrelin in the control of energy balance. Handb Exp Pharmacol. 2012;209:161–84.

    Article  CAS  Google Scholar 

  50. Guimarães M, Nora M, Ferreira T, et al. Sleeve gastrectomy and gastric plication in the rat result in weight loss with different endocrine profiles. Obes Surg. 2013;23(5):710–7.

    Article  PubMed  Google Scholar 

  51. Tschop M, Weyer C, Tataranni PA, et al. Circulating ghrelin levels are decreased in human obesity. Diabetes. 2001;50(4):707–9.

    Article  CAS  PubMed  Google Scholar 

  52. Raghay K, Akki R, Bensaid D, et al. Ghrelin as an anti-inflammatory and protective agent in ischemia/reperfusion injury. Peptides. 2020;124:170226.

    Article  CAS  PubMed  Google Scholar 

  53. WangY, Liu J. Plasma ghrelin modulation in gastric band operation and sleeve gastrectomy. Obes Surg. 2009;19:357–62.

    Article  Google Scholar 

  54. Eleni S, George T, Konstantinos P, et al. Impact of laparoscopic sleeve gastrectomy on gastrointestinal motility. Gastroenterol Res Pract. 2018;4(5):1–17.

    Google Scholar 

  55. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.

    Article  PubMed  Google Scholar 

  56. Abdelbaki TN. An insight on the superior outcome of sleeve gastrectomy over gastric plication. Surg Obes Relat Dis. 2015;11:733–4.

    Article  PubMed  Google Scholar 

  57. Buchwald H, Avidar I, Brannwald E. Bariatric surgery: a systematic review and meta-analysis. JAMA. 292:1724–37.

  58. Harvey EJ, Arroyo K, Korner J, et al. Hormone changes affecting energy homeostasis after metabolic surgery. Mt Sinai J Med. 2010;77(5):446–65.

    Article  PubMed  Google Scholar 

  59. Rogula T. Feasibility and early outcomes of laparoscopic plicated sleeve gastrectomy: a case-control study. Medical Studies. 2015;4:235–40.

    Article  Google Scholar 

  60. Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and complications in a series of 135patients. Obes Surg. 2011;21(11):1657–63.

    Article  PubMed  Google Scholar 

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Author notes

  1. Haoran Li and Weiqiang Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wannan Medical College, 2 Zheshan West Road, Wuhu, Anhui Province, China

    Haoran Li, Junfeng Wang, Weiqiang Wang, Xu Wang, Zhichao Xu, Hanwen Li & Hai Wu

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  1. Haoran Li
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  4. Xu Wang
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Correspondence to Junfeng Wang.

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Key Points

• The advantages of LSG in terms of short- and mid-term weight loss were documented

• LSG has a lower rate of minor complications, but was less cost effective

• LSG and LGCP were similar regarding comorbidities improvement and major complications

• LSG and LGCP were similar in terms of operation duration and hospital stay

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Li, H., Wang, J., Wang, W. et al. Comparison Between Laparoscopic Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication Treatments for Obesity: an Updated Systematic Review and Meta-Analysis. OBES SURG 31, 4142–4158 (2021). https://doi.org/10.1007/s11695-021-05538-z

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  • DOI: https://doi.org/10.1007/s11695-021-05538-z

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