Abstract

Background: Intragstric balloons (IGB) are space-occupying devices that are inserted endoscopically into the stomach and removed after approximately 6 months for the treatment of obesity. IGBs are associated with short-term weight loss while having the advantage of preserving the normal anatomy of the stomach. The long-term efficacy of IGB on weight loss is still questioned. .

Objectives: To determine the short- and long-term efficacy of IGB for the treatment of obesity.

Methods: A systematic review and meta-analysis of the weight changes and BMI changes in patients who underwent an IGB procedure for obesity treatment was conducted. Articles that reported the mean and standard deviation of BMI and weight, and the number of patients before IGB insertion and at the time of IGB removal were selected. The shortterm outcomes were assessed from the IGB insertion to its removal. The Long-term outcomes were assessed from six months and beyond from removal of the IGB. The comprehensive literature search was performed using search engines, PubMed, and other sources. The methodological index for non-randomized studies (MINORS) was used to assess the methodological quality of the studies. Guidelines and protocols as per the "PRISMA guidelines" were adhered to during the systematic review and meta-analysis.

Results: A total of 27 articles were reviewed for the systematic review. The total number of patients at the time of IGB insertion was 4400. The short-term treatment effect of the IGB on obesity was assessed by meta-analysis of 15 articles. The observed standardized mean differences ranged from 0.2949 to 1.5596, with most estimates being positive (100%). The estimated average standardized mean difference based on the random-effects model was 0.7540 (95% CI: 0.5546 to 0.9535). Therefore, the average outcome differed significantly from zero (z = 7.4106, p < 0.0001).

A total of six studies were included in the analysis to assess the long-term effect of IGB treatment on obesity. The observed standardized mean differences ranged from -0.3239 to 0.0000, with most estimates being negative (83%). The estimated average standardized mean difference based on the random-effects model was -0.0961 (95% CI: -0.2113 to 0.0190). Therefore, the average outcome did not differ significantly from zero (z = -1.6364, p = 0.1018).

Conclusion: Intragastric balloons are effective in the treatment of obesity in the short-term. The meta-analysis did not show a beneficial effect on the treatment of obesity after removal.

Keywords: Obesity; Intra-gastric balloon; Bio-enteric intra-gastric balloon; Gastric balloon