Eficacia de la gastroplastía endoscópica en comparación con la manga gástrica en la reducción de peso en pacientes con obesidad: Revisión sistemática

Abstract

Introduction: Obesity is a chronic disease with high prevalence in Latin America and serious public health implications. In light of the failure of conventional measures, sleeve gastrectomy and endoscopic gastroplasty (ESG) have emerged as effective treatments. Objective: To determine the efficacy of endoscopic gastroplasty versus sleeve gastrectomy in terms of weight reduction, comorbidity remission, and complications in patients with obesity. Methodology: The study included human studies in English or Spanish, published within the last five years, involving patients over 18 years of age. Searches were conducted in PubMed and Scopus between November 2024 and April 2025. The risk of bias was assessed using the RoB 2 and JBI tools. Results were narratively synthesized based on the type of intervention and outcome. Results: Sleeve gastrectomy showed greater long-term weight loss (up to 73.5% EWL) compared to ESG (15–20% at 12 months). Both techniques resulted in comorbidity remission; however, ESG had fewer complications. Discussion: The main difference between the two procedures lies in the fact that sleeve gastrectomy offers greater efficacy in weight loss and comorbidity remission, while endoscopic gastroplasty stands out for its lower invasiveness and complication rate. Conclusions: Sleeve gastrectomy is more effective for weight loss, while endoscopic gastroplasty presents fewer complications. The choice of procedure should be adapted to the patient's clinical profile.