Lopez-Nava Gontrand, Galvão M P, Bautista-Castaño I, Fernandez-Corbelle J P, Trell M, Lopez N
Bariatric Endoscopy Unit, Madrid Sanchinarro University Hospital, Madrid, Spain.
Arq Bras Cir Dig. 2017 Jan-Mar;30(1):18-20. doi: 10.1590/0102-6720201700010006.
Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss.
Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation. Of the154 initial patients, 143 were available for 1-month of follow-up, 133 for 6-month, 64 for 12-month and 28 completed the 24 month assessment. Follow-up was carried out by a multidisciplinary team (nutritionist and psychologist). Outcomes evaluated were: change in BMI; change in body weight (TBWL); % of loss of initial body weight (%TBWL); % of excess body weight loss (%EWL) (segregated in > or <25% and adverse effects. Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure.
Mean age was 44.9 (23-69) years. At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2. TBWL, %TBWL and %EWL were of 21.3 kg, 19.5% and 60.4% respectively. 85.7% of patients achieve the goal of >25% %EWL. There were no mayor adverse events intraprocedure or during the 24 months of follow-up .
Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective, safe and well tolerated procedure for obesity treatment, at least for two years of follow-up.
减重内镜技术具有微创性，可减少胃容积以治疗肥胖症。目的：评估采用针对大弯侧的缝合方法进行的内镜下袖状胃成形术（阿波罗法），以及围手术期护理、两年安全性和体重减轻情况。
对154例患者（108例女性）进行前瞻性单中心研究，在全身麻醉下采用内镜下袖状胃成形术，并进行过夜住院观察。在最初的154例患者中，143例可进行1个月的随访，133例可进行6个月的随访，64例可进行12个月的随访，28例完成了24个月的评估。随访由多学科团队（营养师和心理学家）进行。评估的结果包括：体重指数（BMI）的变化；体重变化（TBWL）；初始体重减轻百分比（%TBWL）；多余体重减轻百分比（%EWL）（分为>或<25%）以及不良反应。安排了自愿口服对比放射学检查，以在术后不同时间评估胃成形术情况。
平均年龄为44.9岁（23 - 69岁）。术后24个月时，基线平均BMI从38.3降至30.8kg/m²。TBWL、%TBWL和%EWL分别为21.3kg、19.5% 和60.4%。85.7% 的患者实现了>25% %EWL的目标。术中及24个月随访期间均未发生重大不良事件。
在内镜下袖状胃成形术并由多学科团队进行定期监测的情况下，可以认为该手术是一种有效、安全且耐受性良好的肥胖症治疗方法，至少在两年的随访期内如此。
