Internal Medicine and Gastroenterology Unit, New S'Agostino Hospital, Modena, Italy.
Obes Surg. 2010 Sep;20(9):1227-30. doi: 10.1007/s11695-008-9786-2. Epub 2008 Dec 10.
Overweight and obesity lead to serious health consequences, so that many strategies were recommended for preventing or curing this emerging problem. Treatments are various: diet, physical activity, psychotherapy, drugs, and bariatric surgery. Moreover, during these years, the use of intragastric balloon (BIB) to treat obesity increased rapidly, aimed to (1) reduce bariatric surgical risks; (2) reduce general surgical risks; (3) lead to a significant reduction in the prevalence of cardiovascular diseases, diabetes, musculoskeletal disorders and some cancers. Recently, a new device inflated with air to reduce weight has been developed since 2004 (Heliosphere BAG).
Between March 2006 and September 2006, in our unit, intragastric air-filled balloon insertion was performed under general anesthesia and endoscopic control. The balloons were removed after 6 months. We evaluated efficacy, tolerance, and safety of this technique. Seventeen patients (eight men, nine women), with a mean age of 43 +/- 10 years (range 18-65), mean basal BMI of 46 +/- 8 (range 35-58) were included, after providing informed consent. Weight and BMI loss were evaluated in all patients.
BMI decreased 4 +/- 3 (range +0.33/-11), weight loss was 11 +/- 9 kg (range +1/-29.5; 8.5%). 14/17 patients maintain a BMI > 35 at the time of balloon removal. The difference between initial weight and BMI was statistically significant (p = 0.02 for weight and p < 0.01 for BMI, T Student test). Tolerance was very good, limited only to some dyspeptic symptoms during the first 3 days after insertion. One asymptomatic gastric ulcer was seen at the removal of balloon. Only one severe adverse effect was registered at the time of insertion (acute coronary syndrome in patient with chronic coronary disease). No serious technical problems were noted at balloon insertion. Balloon removal was more difficult and successful in 15/17 cases (one distal migration and one patient led to surgery because of balloon fragmentation).
Intragastric air-filled balloon showed a good profile of efficacy and tolerance. Weight loss appeared to be equivalent to other type of balloons. On the other hand, technical problems (especially at the time of removal) probably linked to the device's material, set a low safety profile.
超重和肥胖会导致严重的健康后果,因此出现了许多预防或治疗这种新出现问题的策略。治疗方法多种多样,包括饮食、身体活动、心理治疗、药物和减肥手术。此外,近年来,胃内球囊(BIB)的使用迅速增加,旨在:(1)降低减肥手术的风险;(2)降低普通外科手术的风险;(3)显著降低心血管疾病、糖尿病、肌肉骨骼疾病和某些癌症的患病率。最近,一种新的充气减重设备(Heliosphere BAG)于 2004 年研发成功。
2006 年 3 月至 2006 年 9 月,在我院,全身麻醉和内镜控制下进行胃内充气球囊插入术。6 个月后取出球囊。我们评估了这项技术的疗效、耐受性和安全性。17 名患者(8 名男性,9 名女性),平均年龄 43 +/- 10 岁(范围 18-65 岁),平均基础 BMI 为 46 +/- 8(范围 35-58),均知情同意。所有患者均评估体重和 BMI 减轻情况。
BMI 下降 4 +/- 3(范围+0.33/-11),体重减轻 11 +/- 9 kg(范围+1/-29.5;8.5%)。17 例患者中有 14 例在球囊取出时 BMI>35。初始体重和 BMI 的差异有统计学意义(体重 T 检验,p = 0.02;BMI 检验,p < 0.01)。耐受性非常好,仅在插入后 3 天内出现一些消化不良症状。取出球囊时发现 1 例无症状性胃溃疡。仅在插入时发生 1 例严重不良事件(慢性冠心病患者发生急性冠状动脉综合征)。插入时未发现严重技术问题。17 例中有 15 例(1 例球囊远端迁移,1 例因球囊破裂而手术)的球囊取出更困难且成功。
胃内充气球囊具有良好的疗效和耐受性。体重减轻似乎与其他类型的球囊相当。另一方面,与器械材料相关的技术问题(尤其是在取出时)安全性较低。