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Comparação entre a gastroplastia endoscópica e a gastrectomia laparoscópica em termos de eficácia e segurança no controlo da síndrome metabólica
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Authors
Abstract(s)
Introdução: A obesidade é um problema de saúde global associado a maior
morbilidade e mortalidade, com impactos significativos nos sistemas de saúde.
Endoscopic Sleeve Gastroplasty (ESG) e Laparoscopic Sleeve Gastrectomy (LSG) são
duas intervenções bariátricas direcionadas para a obtenção de uma perda de peso
sustentada e para melhoria das comorbilidades relacionadas com a obesidade.
Objetivos: Avaliar se a gastroplastia endoscópica pode ser uma alternativa à
gastrectomia laparoscópica no controlo da obesidade e melhoria do perfil metabólico.
Métodos: Foi realizada uma revisão sistemática de estudos identificados na Medline
(via PubMed) e Scopus, entre 2014 e 2024. Os outcomes primários incluíram a
percentagem de perda total de peso (%TBWL), percentagem de perda de excesso de
peso (%EWL) e melhoria de comorbilidades (como diabetes, hipertensão e
dislipidemia), os outcomes secundários incluíram taxas de complicações e eventos
adversos.
Resultados: Foram incluídos oito estudos envolvendo 7045 doentes com obesidade
(IMC = 30). Tanto a ESG como a LSG demonstraram perdas de peso superiores a 10% e
alcançaram melhorias significativas relativamente ao perfil metabólico. A LSG atingiu
perdas de peso superiores à ESG. No entanto, a ESG exibiu um perfil de segurança mais
favorável, com menores taxas de complicações graves e tempos de recuperação mais
rápidos, destacando-se como uma opção minimamente invasiva.
Conclusão: A ESG, de modo análogo à LSG, revela-se eficaz e segura no tratamento
da obesidade e das suas comorbilidades. A LSG demonstrou reduções no peso
superiores, porém é uma técnica mais invasiva. A ESG, por outro lado, oferece uma
alternativa segura e menos radical com benefícios significativos, particularmente para
doentes com obesidade grau I e II. A escolha entre as duas técnicas deve ser, contudo,
baseada no perfil do doente, nos objetivos de perda de peso e no risco cirúrgico.
Introduction: Obesity is a major global health problem, contributing to increased morbidity and mortality and placing a significant burden on healthcare systems. Both Endoscopic Sleeve Gastroplasty (ESG) and Laparoscopic Sleeve Gastrectomy (LSG) are established bariatric procedures designed to achieve sustained weight loss and improve obesity-related metabolic conditions. Objectives: Evaluate whether if ESG can be considered a viable alternative to LSG in managing obesity and improving metabolic outcomes. Methods: A systematic review was conducted, including studies published between 2014 and 2024 identified in Medline (via PubMed) and Scopus. The primary outcomes assessed were the percentage of total body weight loss (%TBWL), percentage of excess weight loss (%EWL), and improvement in obesity-related comorbidities such as diabetes, hypertension, and dyslipidemia.Secondary outcomes focused on complication rates and adverse events. Results: Eight studies were included in this review with a total of 7045 patients with obesity (BMI = 30). Both ESG and LSG achieved weight loss exceeding 10% and significant improvements in the metabolic profile. LSG resulted in greater weight loss compared to ESG. However, ESG showed a more favorable safety profile, including lower rates of severe complications and shorter recovery times, highlighting its role as a less invasive alternative. Conclusion: ESG, similarly to LSG, proved to be effective and safe in the treatment of obesity and its related comorbidities. LSG showed greater weight reductions; however, it is a more invasive technique. ESG, on the other hand, offers a safer and less radical alternative with significant benefits, especially for patients with grade I/II obesity. Nevertheless, the choice between the two procedures shoud be based on patient’s proflife, weight loss goals and surgical risk.
Introduction: Obesity is a major global health problem, contributing to increased morbidity and mortality and placing a significant burden on healthcare systems. Both Endoscopic Sleeve Gastroplasty (ESG) and Laparoscopic Sleeve Gastrectomy (LSG) are established bariatric procedures designed to achieve sustained weight loss and improve obesity-related metabolic conditions. Objectives: Evaluate whether if ESG can be considered a viable alternative to LSG in managing obesity and improving metabolic outcomes. Methods: A systematic review was conducted, including studies published between 2014 and 2024 identified in Medline (via PubMed) and Scopus. The primary outcomes assessed were the percentage of total body weight loss (%TBWL), percentage of excess weight loss (%EWL), and improvement in obesity-related comorbidities such as diabetes, hypertension, and dyslipidemia.Secondary outcomes focused on complication rates and adverse events. Results: Eight studies were included in this review with a total of 7045 patients with obesity (BMI = 30). Both ESG and LSG achieved weight loss exceeding 10% and significant improvements in the metabolic profile. LSG resulted in greater weight loss compared to ESG. However, ESG showed a more favorable safety profile, including lower rates of severe complications and shorter recovery times, highlighting its role as a less invasive alternative. Conclusion: ESG, similarly to LSG, proved to be effective and safe in the treatment of obesity and its related comorbidities. LSG showed greater weight reductions; however, it is a more invasive technique. ESG, on the other hand, offers a safer and less radical alternative with significant benefits, especially for patients with grade I/II obesity. Nevertheless, the choice between the two procedures shoud be based on patient’s proflife, weight loss goals and surgical risk.
Description
Keywords
Gastrectomia Laparoscópica Gastroplastia Endoscópica Obesidade Tratamento