Comparative Efficacy and Safety of Laparoscopic Greater Curvature Plication and Laparoscopic Sleeve Gastrectomy: A Meta-analysis

摘要

Laparoscopic greater curvature plication (LGCP) is considered to have evolved from less invasive laparoscopic sleeve gastrectomy (LSG). In the present meta-analysis, we compared these two procedures in terms of efficacy and safety. We searched PubMed, Embase, and the Cochrane Library from database inception until April 2015. Excess weight loss (%EWL), resolution of obesity-related comorbidities, adverse events, operation time, and postoperative hospital stay were evaluated using the software Review Manager 5.3. The following four studies were eligible for inclusion: one randomized controlled trial and three non-randomized controlled trials involving 299 patients. Our meta-analysis demonstrated a significantly greater %EWL after LSG than LGCP at the follow-up time points of 3 months (Z = 2.26, p = 0.02), 6 months (Z = 4.49, p < 0.00001), and 12 months (Z = 6.99, p < 0.00001). The difference in the resolution of diabetes mellitus between these two approaches did not reach statistical significance (p = 0.66). According to the pooled data, LGCP was associated with more adverse events than was LSG (p = 0.01). The operation time (p = 0.54) and postoperative hospital stay (p = 0.44) were comparable between the two groups. LGCP is inferior to LSG not only in terms of providing effective weight loss but also in terms of safety.