Laparoscopic Gastric Plication versus Laparoscopic Sleeve Gastrectomy: An Up-to-Date Systematic Review and Meta-Analysis

J Obes. 2018 Oct 9:2018:3617458. doi: 10.1155/2018/3617458. eCollection 2018.

Abstract

Introduction: A meta-analysis was conducted in order to provide an up-to-date comparison of laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric plication (LGP) for morbid obesity.

Materials and methods: The PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were used for the conduction of this study. A systematic literature search was performed in the electronic databases (MEDLINE, CENTRAL, and Web of Science and Scopus). The fixed effects or random effects model was used according to the Cochran Q test.

Results: Totally, 12 eligible studies were extracted. LSG displayed a statistically significant lower rate of overall complications (OR: 0.35; 95% CI: 0.17, 0.68; p=0.002) and a sustainable higher %EWL through all time endpoints (OR: 4.86, p=0.04; OR: 7.57, p < 0.00001; and OR: 13.74; p < 0.00001). There was no difference between the two techniques in terms of length of hospital stay (p=0.16), operative duration (p=0.81), reoperation rate (p=0.51), and cost (p=0.06).

Conclusions: LSG was demonstrated to have a lower overall complications and a higher weight loss rate, when compared to LGP. Further RCTs of a higher methodological quality level, with a larger sample size, are required in order to validate these findings.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Gastrectomy* / methods
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid / surgery*
  • Postoperative Complications / surgery*
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss / physiology*