Evans J D, Scott M H
Department of Surgery, Whiston Hospital, Warrington Road, Merseyside L35 5DR, UK.
Br J Surg. 2001 Sep;88(9):1245-8. doi: 10.1046/j.0007-1323.2001.01840.x.
Morbid obesity is a major health problem. This study evaluated the effectiveness and safety of an intragastric balloon (IGB) for the treatment of morbid obesity.
Sixty-nine IGBs were inserted endoscopically over a 3-year period in 63 consecutive patients (59 women; median age 41 (range 24-67) years). Median weight and body mass index were 124.5 (range 89.0-177.8) kg and 46.3 (range 36.2-72.4) kg/m(2) respectively. Significant coexistent disease was present in 34 patients. Median American Society of Anesthesiologists score was 3 (range 1-4). Data were recorded following retrospective review of patient case notes.
Mean operating time was 22 (range 15-30) min and median inpatient stay was 1 (range 1-6) day. Vomiting was the commonest early complication following 31 procedures and necessitated early removal of four IGBs. Of 58 patients with long-term follow-up, 18 suffered displacement of the IGB after at least 6 months in situ and three required a laparotomy for intestinal obstruction. Fifty patients (86 per cent) lost weight; median weight loss was 15.0 kg (P < 0.001). Median excess weight loss was 16.4 (range - 49.0 to + 4.8) and 18.7 (range - 51.5 to 12.6) per cent by 4 and 7 months after IGB insertion respectively.
The IGB represents a useful device for the treatment of morbid obesity, particularly in preparation for definitive antiobesity procedures. Early IGB replacement is essential to minimize complications.
病态肥胖是一个主要的健康问题。本研究评估了胃内气球(IGB)治疗病态肥胖的有效性和安全性。
在3年时间里,通过内镜为63例连续患者(59例女性;中位年龄41岁(范围24 - 67岁))置入了69个IGB。中位体重和体重指数分别为124.5 kg(范围89.0 - 177.8 kg)和46.3 kg/m²(范围36.2 - 72.4 kg/m²)。34例患者存在显著的并存疾病。美国麻醉医师协会中位评分为3分(范围1 - 4分)。通过回顾患者病历记录来记录数据。
平均手术时间为22分钟(范围15 - 30分钟),中位住院时间为1天(范围1 - 6天)。呕吐是31例手术后最常见的早期并发症,4个IGB因呕吐而需要提前取出。在58例接受长期随访的患者中,18例在IGB原位放置至少6个月后出现移位,3例因肠梗阻需要进行剖腹手术。50例患者(86%)体重减轻;中位体重减轻为15.0 kg(P < 0.001)。IGB置入后4个月和7个月时,中位超重减轻分别为16.4%(范围 - 49.0至 + 4.8%)和18.7%(范围 - 51.5至12.6%)。
IGB是治疗病态肥胖的一种有用装置,特别是在为确定性减肥手术做准备时。早期更换IGB对于将并发症降至最低至关重要。