TY - JOUR
T1 - Primary obesity surgery endoluminal (POSE) for the treatment of obesity
T2 - a systematic review and meta-analysis
AU - Singh, Shailendra
AU - Bazarbashi, Ahmad Najdat
AU - Khan, Ahmad
AU - Chowdhry, Monica
AU - Bilal, Mohammad
AU - de Moura, Diogo Turiani Hourneaux
AU - Jirapinyo, Pichamol
AU - Thakkar, Shyam
AU - Thompson, Christopher C.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
PY - 2022/1
Y1 - 2022/1
N2 - Background: Primary obesity surgery endoluminal (POSE) utilizes an incision-less operating platform system to create full-thickness plications in the gastric fundus and body (original POSE). Many studies have demonstrated the safety and efficacy of original POSE for the treatment of obesity. Objective: We aimed to conduct a systematic review and meta-analysis of available literature in an attempt to evaluate the outcomes of original POSE per the ASGE task force thresholds. Methods: Bibliographic databases were systematically searched for studies assessing the outcomes of POSE for the treatment of obesity. All randomized controlled trials (RCTs) and observational studies that assessed outcomes of POSE were included. Studies were included if they reported percent total weight loss (%TWL) or percent excess weight loss (%EWL) and the incidence of serious adverse events (SAE). Results: A total of seven studies with 613 patients were included. Two included studies were RCTs, while the remaining were observational studies. Pooled mean %EWL at 3–6 months and 12–15 months were 42.62 (95% CI 37.56–47.68) and 48.86 (95% CI 42.31–55.41), respectively. Pooled mean %TWL at 3–6 months and 12–15 months was 13.45 (95% CI 8.93–17.97) and 12.68 (95% CI 8.13–17.23), respectively. Subgroup analysis of two RCTs showed that weight loss at 1 year was significantly higher in POSE patients (%EWL difference in means 19.45 (95% CI 4.65–34.24, p value = 0.01). The overall incidence of serious adverse events was only 2.84% and included GI bleeding, extra-gastric bleeding, hepatic abscess, severe pain, severe nausea, and severe vomiting. The mean number of total anchors placed in the fundus and body was 13.18 (95% CI 11.77–14.58), and the mean procedure time was 44.55 min (95% CI 36.44–52.65). Conclusion: POSE, a minimally invasive endoscopic bariatric therapy, is a safe and effective modality for the treatment of obesity. The outcomes of POSE meet and surpass the ASGE joint task force thresholds. Future studies should evaluate newer versions of this procedure that emphasize gastric body plication sparing the fundus.
AB - Background: Primary obesity surgery endoluminal (POSE) utilizes an incision-less operating platform system to create full-thickness plications in the gastric fundus and body (original POSE). Many studies have demonstrated the safety and efficacy of original POSE for the treatment of obesity. Objective: We aimed to conduct a systematic review and meta-analysis of available literature in an attempt to evaluate the outcomes of original POSE per the ASGE task force thresholds. Methods: Bibliographic databases were systematically searched for studies assessing the outcomes of POSE for the treatment of obesity. All randomized controlled trials (RCTs) and observational studies that assessed outcomes of POSE were included. Studies were included if they reported percent total weight loss (%TWL) or percent excess weight loss (%EWL) and the incidence of serious adverse events (SAE). Results: A total of seven studies with 613 patients were included. Two included studies were RCTs, while the remaining were observational studies. Pooled mean %EWL at 3–6 months and 12–15 months were 42.62 (95% CI 37.56–47.68) and 48.86 (95% CI 42.31–55.41), respectively. Pooled mean %TWL at 3–6 months and 12–15 months was 13.45 (95% CI 8.93–17.97) and 12.68 (95% CI 8.13–17.23), respectively. Subgroup analysis of two RCTs showed that weight loss at 1 year was significantly higher in POSE patients (%EWL difference in means 19.45 (95% CI 4.65–34.24, p value = 0.01). The overall incidence of serious adverse events was only 2.84% and included GI bleeding, extra-gastric bleeding, hepatic abscess, severe pain, severe nausea, and severe vomiting. The mean number of total anchors placed in the fundus and body was 13.18 (95% CI 11.77–14.58), and the mean procedure time was 44.55 min (95% CI 36.44–52.65). Conclusion: POSE, a minimally invasive endoscopic bariatric therapy, is a safe and effective modality for the treatment of obesity. The outcomes of POSE meet and surpass the ASGE joint task force thresholds. Future studies should evaluate newer versions of this procedure that emphasize gastric body plication sparing the fundus.
KW - EBMTs
KW - Endoscopic bariatric and metabolic therapies
KW - Endoscopic bariatric therapy
KW - Endoscopic gastroplasty
KW - POSE
KW - Primary obesity surgery endoluminal
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=85100094566&partnerID=8YFLogxK
U2 - 10.1007/s00464-020-08267-z
DO - 10.1007/s00464-020-08267-z
M3 - Article
C2 - 33523277
AN - SCOPUS:85100094566
SN - 0930-2794
VL - 36
SP - 252
EP - 266
JO - Surgical endoscopy
JF - Surgical endoscopy
IS - 1
ER -