Mathus-Vliegen Elisabeth M H
Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Obes Surg. 2018 Jan;28(1):169-175. doi: 10.1007/s11695-017-2812-5.
Gastric balloons for weight loss have historically been placed after a screening endoscopy. However, the utility and yield of these endoscopies has not been studied. Therefore, we wanted to evaluate the utility of screening endoscopy and to assess patients who had balloons placed without endoscopy.
Data was collected on two cohorts. Cohort 1 consisted of patients who had a screening endoscopy prior to or upon balloon placement. Cohort 2 consisted of patients who were followed after having a balloon placed under fluoroscopic guidance without endoscopy. Balloon intolerance and findings on removal endoscopy were assessed in both cohorts.
In cohort 1 (n = 253), two patients had severe symptoms on history; balloon placement was contraindicated based on screening endoscopy findings. Eleven patients with a history of hiatal hernia and the presence of severe belching demonstrated an insignificant hiatal hernia on endoscopy. In cohort 2 (n = 50), all patients had an unremarkable history. Three previously asymptomatic patients had balloon intolerance and one was found to have a 4-cm hiatal hernia and oesophagitis upon balloon removal. Out of 194 patients, 25 were either intolerant to the balloon or had relevant findings on removal endoscopy. Findings on screening endoscopy did not correlate with balloon intolerance or findings on removal endoscopy.
These results demonstrate that a careful history can identify patients who may have contraindications for balloon therapy and that balloons can be placed safely after taking a careful history without screening endoscopy. Screening endoscopy may not be useful in predicting balloon intolerance or potential complications.
历史上，用于减肥的胃内气球是在筛查性内镜检查后放置的。然而，这些内镜检查的效用和结果尚未得到研究。因此，我们想评估筛查性内镜检查的效用，并评估那些未进行内镜检查就放置了气球的患者。
收集了两个队列的数据。队列1由在放置气球之前或之时进行了筛查性内镜检查的患者组成。队列2由在没有内镜检查的情况下在荧光镜引导下放置气球后接受随访的患者组成。在两个队列中均评估了气球不耐受情况以及取出内镜检查的结果。
在队列1（n = 253）中，有两名患者有严重症状史；根据筛查性内镜检查结果，放置气球是禁忌的。11名有食管裂孔疝病史且有严重嗳气症状的患者在内镜检查中显示食管裂孔疝不明显。在队列2（n = 50）中，所有患者病史均无异常。三名之前无症状的患者出现了气球不耐受情况，一名患者在取出气球时被发现有4厘米的食管裂孔疝和食管炎。在194名患者中，25名患者对气球不耐受或在取出内镜检查时有相关发现。筛查性内镜检查的结果与气球不耐受情况或取出内镜检查的结果无关。
这些结果表明，仔细询问病史可以识别出可能有气球治疗禁忌证的患者，并且在仔细询问病史后，不进行筛查性内镜检查也可以安全地放置气球。筛查性内镜检查可能无助于预测气球不耐受情况或潜在并发症。
