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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2022.tde-01032023-161502
Document
Author
Full name
Antonio Afonso de Miranda Neto
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Moura, Diogo Turiani Hourneaux de (President)
Chaim, Elinton Adami
Malheiros, Carlos Alberto
Santo, Marco Aurelio
Title in Portuguese
Gastroplastia endoscópica no manejo dos pacientes com sobrepeso e obesidade: revisão sistemática e metanálise
Keywords in Portuguese
Cirurgia bariátrica
Endoscopia
Endoscopia gastrointestinal
Gastroplastia
Obesidade
Procedimentos cirúrgicos endoscópicos do sistema digestório
Abstract in Portuguese
Introdução e objetivo: a gastroplastia endoscópica (GE) é um procedimento endoscópico realizado utilizando dispositivo que permite a sutura gástrica, reduzindo o tamanho e promovendo retardo do esvaziamento, resultando em saciedade precoce, visando promover a perda de peso. O objetivo deste estudo é avaliar a eficácia e a segurança desta técnica. Métodos: este estudo trata-se de revisão sistemática e metanálise realizada de acordo com as diretrizes do PRISMA. Bases de dados eletrônicas foram utilizadas para a identificação de estudos que avaliaram os resultados da GE. Os desfechos analisados foram a perda de peso absoluta (PPA), porcentagem de perda de excesso de peso (%PEP), porcentagem de perda de peso total (%PPT), e eventos adversos (EA) no período entre 1 mês e 2 anos. A análise do risco de viés foi feita utilizando a ferramenta do Joanna Briggs Institute. A avaliação da qualidade de evidência foi feita utilizando o software GRADEpro. A análise estatística foi realizada utilizando o programa Comprehensive Meta-Analysis Software. Registro PROSPERO: CRD42019137654. Resultados: quinze estudos com um total de 2.544 pacientes foram incluídos na metanálise. A média do índice de massa corporal da população incluída foi de 35,4 kg/m2. A %PPT observada em 6, 12, 18 e 24 meses foi 14,9%, 16,7%, 16,4% e 16,5% respectivamente; e a %PEP de 52,3%, 55%, 73,3% e 61% respectivamente. A taxa de EA graves foi de 0,8% e nenhum óbito foi reportado. Conclusão: a GE é um procedimento seguro e efetivo como terapia endoscópica primária para o manejo do sobrepeso e obesidade no seguimento de curto prazo
Title in English
Endoscopic sleeve gastroplasty in the management of patients with overweight and obesity: systematic review and meta-analysis
Keywords in English
Bariatric surgery
Endoscopic gastrointestinal surgical procedures
Endoscopy
Gastrointestinal endoscopy
Gastroplasty
Obesity
Abstract in English
Introduction and aims: endoscopic sleeve gastroplasty (ESG) is an endoscopic procedure performed using a specific device, that allows gastric sutures, reducing the size and promoting delayed gastric emptying, resulting in early satiety, aiming to promote weight loss. We aimed to perform a systematic review and meta-analysis to provide an update on its efficacy and safety. Methods: this systematic review and meta-analysis was performed following the PRISMA guidelines. Electronic databases were used to identify studies that evaluated ESG results. The outcomes analyzed were absolute weight loss (AWL), percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and adverse events (AE), between 1 month and 2 years. The risk of bias analysis was performed using the Joanna Briggs Institute tool. Evidence quality assessment was performed using the GRADEpro software. Statistical analysis was performed using the Comprehensive Meta-Analysis Software program. PROSPERO Registry: CRD42019137654. Results: fifteen studies with a total of 2.544 patients were included in the meta-analysis. The average body mass index pre-ESG was 35.4 kg/m2 . %TWL observed at 6, 12, 18 and 24 months was 14.9%, 16.7%, 16.4% and 16.5% respectively. %EWL at 6, 12, 18 and 24 months was 52.3%, 55%, 73.3% and 61% respectively. The rate of serious AE was 0.8%, and no procedure-related mortality was reported. Conclusion: ESG is a safe and effective primary therapy for the treatment of obesity in short-term follow-up
 
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Publishing Date
2023-04-17
 
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