BACKGROUND AND AIMS Gastric stenosis is a rare but potentially serious adverse event after sleeve gastrectomy. Despite current suboptimal treatments, endoscopic balloon dilatation (EBD) has emerged as a safe and efficacious approach. The purpose of this study is to assess the overall success of EBD for sleeve gastrectomy stenosis (SGS) as first-line therapy. METHODS MEDLINE, Embase, Web of Science, Google Scholar, and Cochrane Database were searched from inception to July 2018. The primary outcome was defined as overall success rate of clinical resolution of SGS obstructive symptoms with EBD, expressed as pooled event rate and 95% confidence interval (CI). The secondary predefined outcomes include EBD success rates for SGS in the proximal (cardia) location or mid-distal location (antrum/incisura), in early SGS (up to 3 months after laparoscopic sleeve gastrectomy), and late SGS (3 months or longer after laparoscopic sleeve gastrectomy) and success rate of cases requiring stents or salvage surgery. RESULTS Eighteen studies encompassing 426 patients were analyzed. The average age and body mass index were 41.7 years and 40.1 kg/m2, respectively, and the average number of dilations for all cases was 1.8 per person. Overall EBD success rate was 76% (95% CI, .67-.86). EBD success rate in the proximal SGS was 90% (95% CI, 63%-98%), distal SGS was 70% (95% CI, 47%-86%), early SGS within 3 months was 59% (95% CI, 34%-79%), and late SGS after 3 months was 61% (95% CI, 41%-78%). Seventeen percent of patients underwent secondary salvage surgery, with a success rate of 91% (95% CI, 80%-96%). CONCLUSIONS Endoscopic balloon dilation appears to be a safe and effective minimally invasive alternative to surgical revision and should be used as first-line therapy for SGS.

中文翻译：

---

内窥镜球囊扩张术治疗袖状胃切除术狭窄：系统评价和荟萃分析。

背景与目的胃狭窄是袖式胃切除术后罕见但潜在的严重不良事件。尽管目前的治疗方法欠佳，但内镜下球囊扩张术（EBD）已成为一种安全有效的方法。这项研究的目的是评估EBD作为一线治疗在袖状胃切除术狭窄（SGS）方面的总体成功。方法检索从开始到2018年7月的MEDLINE，Embase，Web of Science，Google Scholar和Cochrane数据库。主要结局定义为合并EBS的SGS阻塞性症状临床缓解的总体成功率，表示为合并事件发生率和95％置信区间（CI）。次要预定义结果包括近端（心脏）位置或中远端位置（窦/切牙）SGS的EBD成功率，SGS早期（腹腔镜袖胃切除术后最多3个月）和SGS后期（腹腔镜袖胃切除术后3个月或更长时间）以及需要支架或抢救手术的病例的成功率。结果分析了426例患者的18项研究。平均年龄和体重指数分别为41.7岁和40.1 kg / m2，所有病例的平均扩张次数为每人1.8。总体EBD成功率为76％（95％CI，.67-.86）。近端SGS的EBD成功率为90％（95％CI，63％-98％），远端SGS为70％（95％CI，47％-86％），3个月内早期SGS为59％（95％） CI为34％-79％）和3个月后的SGS晚期为61％（95％CI为41％-78％）。17％的患者接受了二次抢救手术，成功率为91％（95％CI，80％-96％）。