Background

Endoscopic sleeve gastroplasty (ESG) stands as the latest primary endoscopic intervention for managing obesity. Despite common assumptions regarding its superiority over intragastric balloon (IGB), a scarcity of data-driven evidence exists to substantiate this claim. Our aim was to conduct a pairwise meta-analysis comparing ESG and IGB, a comparison that, to our knowledge, has not been previously published.

Methods

We conducted a systematic literature review following PRISMA guidelines to identify articles directly comparing ESG versus IGB. Utilizing the random effects model, we employed odds ratios for dichotomous data and mean differences for continuous data as metrics for effect size. Comparison of total weight loss percentages (TWL%) was performed at 1 and 6 months; however, analysis at 12 months was deemed methodologically inappropriate due to the typical removal of IGB at the 6-month mark.

Results

While incidences of serious adverse events and readmissions were lower in the ESG group, these differences did not reach statistical significance (p = 0.52 and 0.83, respectively). ESG demonstrated a higher TWL% at 1 and 6 months, with the difference being significant at 1 month (p = 0.009) but not at 6 months (p = 0.1).

Conclusions

To establish more robust conclusions, further studies with larger sample sizes, prolonged IGB placement for 12 months, and randomized double-blinded designs are warranted.