B0630 - Efficacy of Endoscopic Sleeve Gastroplasty in Treatment of Metabolic Syndrome: A Systematic Review and Meta-Analysis

Eric Smith, MD¹, David Ence, BA², Shreyas Saligram, MD^3
1BSW- Round Rock, Round Rock, TX; ²Brigham Young University, Provo, UT; ³UTHSCSA, San Antonio, TX

Introduction: Endoscopic sleeve gastroplasty (ESG) is a novel technique developed as a minimally invasive alternative to laparoscopic sleeve gastrectomy. A minimum of 10% total body weight loss (%TBWL) is required to reverse the metabolic syndrome. Our aim from this meta-analysis is to evaluate if ESG can consistently achieve the minimum %TBWL required to reverse the metabolic syndrome.

Methods: This systematic review and meta-analysis followed PRISMA guidelines and included studies from PubMED up until May 2022. We included peer reviewed studies that contained at least 10 adult patients and tracked (%TBWL) after at least one-month post-procedure and included no other weight loss intervention besides ESG. We looked at improvement in surrogate markers of metabolic syndrome (Ex: Non Alcoholic Steato-Hepatitis (NASH), Diabetes, Dyslipidemia).

Results: Our search resulted in 33 studies that fit inclusion criteria, including 4087 patients in total. Average BMI before intervention was 37.5 kg/m². After pooling weight loss data, we found that percent total weight loss (%TBWL) at 1, 3, 6, 12, 18, and 24 months was 8.9%, 12.9%, 15.6%, 18.0%, 16.4%, and 17.1% respectively. Age, gender, starting BMI, and number of sutures did not correlate with %TBWL at one year. A subgroup analysis of these studies showed an improvement in NASH (decrease of ALT by 19.3 IU/L, CI: 13.3 to 25.8)); diabetes (decrease in HBA1C of 1.2 mmol/mol, CI: 0.83 to 1.5); and dyslipidemia (decrease in triglycerides of 0.6 mmol/L, CI: 0.2 to 1.0). No mortality was reported and severe adverse events were rare (1.8%, CI 1.4% to 2.2%) and associated with older age, but not starting BMI (p=.015; .26).

Discussion: - ESG results in sustained weight loss for up to two years with low complication rates. This was associated with reversal of metabolic syndrome. Further studies should examine long term weight loss results.



Disclosures:


Eric Smith, MD¹, David Ence, BA², Shreyas Saligram, MD³. B0630 - Efficacy of Endoscopic Sleeve Gastroplasty in Treatment of Metabolic Syndrome: A Systematic Review and Meta-Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.