Lopasso Fabio P, Sakai Paulo, Gazi Bashir M, Artifon Everson L A, Kfouri Christiane, Souza Jussara P B, Kumar Atul
Sao Paulo University School of Medicine, Sao Paulo, Brazil.
J Clin Gastroenterol. 2008 Jan;42(1):48-53. doi: 10.1097/01.mcg.0000247992.89215.88.
A 150 cm pear-shaped gastric balloon with a 30 cm-long duodenal stem and a 7 g metallic weight at its distal end was designed and developed to facilitate weight loss by (a) delaying gastric emptying thus enhancing interprandial satiety, and (b) stimulating antral and duodenal receptors of satiation.
Twenty-six patients (body mass index of 29 to 40 kg/m) who failed to lose weight despite dietary intervention underwent endoscopic implantation of the balloon device. Patients were monitored for tolerance to the balloon, complications, weight loss, and compliance with a restricted caloric intake.
Six men and 20 women with a median body weight of 93.0 kg (range, 73.5 to 119.9), median body mass index 34.3 kg/m (range, 28.8 to 39.5) underwent balloon implantation for a median period of 4.0 months (range, 0.75 to 6.0). Twenty-two patients successfully complied with a 1250 to 1500 kcal daily diet restriction during the study period. Median weight reduction was 6.5 kg (range, 3.7 to 19.9). Patients with initial body weight of >90 kg tended to loose more weight (8.1 kg) than patients weighing <90 kg (4.5 kg) (P=0.14). Nine patients with dwell times of 6 months lost 11.5+/-4.6 kg. The balloon malfunctioned in 4 patients (in 1 patient, the balloon leaked spontaneously but remained in the stomach and in 3 patients, the balloon migrated distally).
Our novel balloon device may be effective in inducing weight loss by promoting compliance with a restricted caloric intake and is well tolerated due to its small size. Complications resulted from balloon rupture, which can be easily prevented by enhancements in design and use of alternative materials.
设计并研发了一种150厘米长的梨形胃内球囊,其十二指肠柄长30厘米,远端有一个7克重的金属配重,旨在通过以下方式促进体重减轻:(a)延迟胃排空,从而增强餐间饱腹感;(b)刺激胃窦和十二指肠的饱腹感受体。
26例尽管进行了饮食干预但仍未能减重的患者(体重指数为29至40kg/m)接受了球囊装置的内镜植入。对患者进行球囊耐受性、并发症、体重减轻以及热量摄入限制依从性的监测。
6名男性和20名女性,中位体重为93.0kg(范围73.5至119.9),中位体重指数34.3kg/m(范围28.8至39.5)接受了球囊植入,中位时间为4.0个月(范围0.75至6.0)。22例患者在研究期间成功遵守了每日1250至1500千卡的饮食限制。中位体重减轻为6.5kg(范围3.7至19.9)。初始体重>90kg的患者比体重<90kg的患者减重更多(8.1kg对4.5kg)(P=0.14)。9名留置时间为6个月的患者减重11.5±4.6kg。4例患者出现球囊故障(1例患者球囊自发渗漏但仍留在胃内,3例患者球囊向远端迁移)。
我们的新型球囊装置可能通过促进对热量摄入限制的依从性而有效减轻体重,并且由于其体积小而耐受性良好。并发症是由球囊破裂引起的,通过改进设计和使用替代材料可以很容易地预防。