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经口内镜下胃造口术治疗肥胖症:201 例患者多中心上市后欧洲注册研究的 1-4 年结果。

Aspiration Therapy As a Tool to Treat Obesity: 1- to 4-Year Results in a 201-Patient Multi-Center Post-Market European Registry Study.

机构信息

Department of Surgery, Blekinge County Hospital, Lasarettsvägen, 371 85, Karlskrona, Sweden.

University Hospital Ostrava, Pionyru 690, 250 81, Nehvizdy, Czech Republic.

出版信息

Obes Surg. 2018 Jul;28(7):1860-1868. doi: 10.1007/s11695-017-3096-5.

Abstract

PURPOSE

The objective of this post-market study was to evaluate long-term safety and efficacy of aspiration therapy (AT) in a clinical setting in five European clinics.

MATERIALS AND METHODS

The AspireAssist® System (Aspire Bariatrics, Inc. King of Prussia, PA) is an endoscopic weight loss therapy utilizing a customized percutaneous endoscopic gastrostomy tube and an external device to aspirate approximately 30% of ingested calories after a meal, in conjunction with lifestyle counseling. A total of 201 participants, with body mass index (BMI) of 35.0-70.0 kg/m, were enrolled in this study from June 2012 to December 2016. Mean baseline BMI was 43.6 ± 7.2 kg/m.

RESULTS

Mean percent total weight loss at 1, 2, 3, and 4 years, respectively, was 18.2% ± 9.4% (n/N = 155/173), 19.8% ± 11.3% (n/N = 82/114), 21.3% ± 9.6% (n/N = 24/43), and 19.2% ± 13.1% (n/N = 12/30), where n is the number of measured participants and N is the number of participants in the absence of withdrawals or lost to follow-up. Clinically significant reductions in glycated hemoglobin (HbA1C), triglycerides, and blood pressure were observed. For participants with diabetes, HbA1C decreased by 1% (P < 0.0001) from 7.8% at baseline to 6.8% at 1 year. The only serious complications were buried bumpers, experienced by seven participants and resolved by removal/replacement of the A-Tube, and a single case of peritonitis, resolved with a 2-day course of intravenous antibiotics.

CONCLUSION

This study establishes that aspiration therapy is a safe, effective, and durable weight loss therapy in people with classes II and III obesity in a clinical setting.

TRIAL REGISTRATION

ISRCTN 49958132.

摘要

目的

本上市后研究的目的是评估在欧洲五家诊所的临床环境中,抽吸疗法(AT)的长期安全性和疗效。

材料和方法

AspireAssist®系统(Aspire Bariatrics,Inc.,King of Prussia,PA)是一种内镜减肥治疗方法,使用定制的经皮内镜胃造口管和外部设备,在饭后抽吸约 30%的摄入卡路里,同时结合生活方式咨询。共有 201 名体重指数(BMI)为 35.0-70.0kg/m 的参与者于 2012 年 6 月至 2016 年 12 月参加了这项研究。平均基线 BMI 为 43.6±7.2kg/m。

结果

分别在 1、2、3 和 4 年时的平均总体重减轻百分比为 18.2%±9.4%(n/N=155/173)、19.8%±11.3%(n/N=82/114)、21.3%±9.6%(n/N=24/43)和 19.2%±13.1%(n/N=12/30),其中 n 是测量参与者的数量,N 是无退出或失访的参与者数量。观察到糖化血红蛋白(HbA1C)、甘油三酯和血压的临床显著降低。对于患有糖尿病的参与者,HbA1C 从基线时的 7.8%下降了 1%(P<0.0001),至 1 年时降至 6.8%。唯一的严重并发症是埋入式保险杠,7 名参与者出现该并发症,通过更换或重新放置 A 管得到解决,以及 1 例腹膜炎,通过 2 天的静脉内抗生素治疗得到解决。

结论

本研究表明,在临床环境中,抽吸疗法是一种安全、有效且持久的 II 类和 III 类肥胖人群的减肥疗法。

试验注册

ISRCTN49958132。

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