The role of aspiration therapy and intragastric botulinum toxin A injection in obesity treatment

Abstract

Aspiration therapy (AT) and intragastric injection of botulinum toxin A (gastric botox) are among the current endoscopic techniques used in the treatment of obesity. Both techniques have been preferred by patients and physicians due to their easy applicability, low risk of complications and reversibility. In this systematic review, it was aimed to assess the role of these techniques in obesity treatment. A comprehensive search of several databases including Cochrane Library, Web of Science and PubMed were conducted. Twenty-six clinical studies (10 studies on AT and 16 studies on gastric botox) were included. According to the obtained results, the effects of gastric botox on gastric emptying rate, appetite and weight loss have not been clarified yet. On the other hand, it is clear that AT is effective in weight loss. However, the complications that AT can cause (cardiac arrhythmia, hypokalemia, hypochloremic hypokalemic metabolic alkalosis) are more serious compared to gastric botox. AT can also cause some eating behavior disorders. Considering the physiological risks associated with AT, it may be important to support patients undergoing AT treatment with some supplements such as potassium chloride. Patients treated with AT should be periodically screened for eating disorders, in addition to medical monitoring. • The effect of gastric botox on weight loss has not been clarified yet. • Structure of pylorus is important in the success of gastric botox. • AT can cause cardiac arrhythmia, hypokalemia and hypochloremic metabolic alkalosis. • AT costs more than bariatric surgery in the long term. • Patients undergoing AT treatment may need supplements such as potassium chloride.