Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri.
Gastroenterology. 2013 Dec;145(6):1245-52.e1-5. doi: 10.1053/j.gastro.2013.08.056. Epub 2013 Sep 6.
BACKGROUND & AIMS: Obese patients rarely achieve long-term weight loss with only lifestyle interventions. We evaluated the use of endoscopic aspiration therapy for obesity. Aspiration therapy involves endoscopic placement of a gastrostomy tube (A-Tube) and the AspireAssist siphon assembly (Aspire Bariatrics, King of Prussia, PA) to aspirate gastric contents 20 minutes after meal consumption.
We performed a pilot study of 18 obese subjects who were randomly assigned (2:1) to groups that underwent aspiration therapy for 1 year plus lifestyle therapy (n = 11; mean body mass index, 42.6 ± 1.4 kg/m(2)) or lifestyle therapy only (n = 7; mean body mass index, 43.4 ± 2.0 kg/m(2)). Lifestyle intervention comprised a 15-session diet and behavioral education program.
Ten of the 11 subjects who underwent aspiration therapy and 4 of the 7 subjects who underwent lifestyle therapy completed the first year of the study. After 1 year, subjects in the aspiration therapy group lost 18.6% ± 2.3% of their body weight (49.0% ± 7.7% of excess weight loss [EWL]) and those in the lifestyle therapy group lost 5.9% ± 5.0% (14.9% ± 12.2% of EWL) (P < .04). Seven of the 10 subjects in the aspiration therapy group completed an additional year of therapy and maintained a 20.1% ± 3.5% body weight loss (54.6% ± 12.0% of EWL). There were no adverse effects of aspiration therapy on eating behavior and no evidence of compensation for aspirated calories with increased food intake. No episodes of binge eating in the aspiration therapy group or serious adverse were reported.
In a pilot study, aspiration therapy appears to be a safe and effective long-term weight loss therapy for obesity.
单纯生活方式干预很少能使肥胖患者长期减轻体重。我们评估了内镜抽吸疗法在肥胖治疗中的应用。抽吸疗法包括在内镜下放置胃造口管（A 管）和 AspireAssist 虹吸管组件（Aspire Bariatrics，King of Prussia，PA），在进食后 20 分钟抽吸胃内容物。
我们对 18 名肥胖受试者进行了一项试点研究，这些受试者被随机分配（2:1）到接受抽吸治疗 1 年加生活方式治疗的组（n = 11；平均体重指数为 42.6 ± 1.4 kg/m2）或仅接受生活方式治疗的组（n = 7；平均体重指数为 43.4 ± 2.0 kg/m2）。生活方式干预包括 15 次饮食和行为教育课程。
接受抽吸治疗的 11 名受试者中有 10 名和接受生活方式治疗的 7 名受试者中有 4 名完成了研究的第一年。治疗 1 年后，抽吸治疗组受试者体重减轻了 18.6% ± 2.3%（体重减轻的 49.0% ± 7.7%），生活方式治疗组受试者体重减轻了 5.9% ± 5.0%（体重减轻的 14.9% ± 12.2%）（P <.04）。抽吸治疗组的 7 名受试者完成了额外一年的治疗，并维持了 20.1% ± 3.5%的体重减轻（体重减轻的 54.6% ± 12.0%）。抽吸治疗对进食行为没有不良影响，也没有证据表明通过增加食物摄入来补偿被抽吸的卡路里。抽吸治疗组没有暴食发作或严重不良事件报告。
在一项试点研究中，抽吸疗法似乎是一种安全有效的肥胖长期减肥疗法。
