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Intragastric Balloon Versus Endoscopic Sleeve Gastroplasty for the Treatment of Obesity: a Systematic Review and Meta-analysis

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Abstract

Background

We aimed to individually evaluate IGB and ESG procedures and compare the efficacy, durability, and safety of these procedures.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgments

The authors acknowledge Anna Crawford (Librarian, West Virginia University Health Sciences Library) for conducting the literature searches.

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Authors and Affiliations

  1. Division of Gastroenterology, West Virginia University Health Sciences Center Charleston Division, Charleston, WV, USA

    Shailendra Singh

  2. Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Diogo Turiani Hourneaux de Moura, Michele B. Ryan, Ahmad Najdat Bazarbashi & Christopher C. Thompson

  3. Department of Medicine, West Virginia University Health Sciences Center Charleston Division, Charleston, WV, USA

    Ahmad Khan & Monica Chowdhry

  4. Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Mohammad Bilal

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Correspondence to Shailendra Singh.

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Conflict of Interest

Shailendra Singh, Diogo Turiani Hourneaux de Moura, Ahmad Khan, Mohammad Bilal, Monica Chowdhry, Michele B. Ryan, Ahmad Najdat Bazarbashi declare that they have no conflict of interest. Christopher C Thompson is a consultant for Apollo Endosurgery, USGI medical, Fractyl, Boston Scientific, Medtronic, Olympus, and GI dynamics.

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Singh, S., de Moura, D.T.H., Khan, A. et al. Intragastric Balloon Versus Endoscopic Sleeve Gastroplasty for the Treatment of Obesity: a Systematic Review and Meta-analysis. OBES SURG 30, 3010–3029 (2020). https://doi.org/10.1007/s11695-020-04644-8

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