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老年病态肥胖患者内镜胃内球囊置入治疗后的急性并发症:单中心经验。

Acute complications following endoscopic intragastric balloon insertion for treatment of morbid obesity in elderly patients. A single center experience.

机构信息

Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy -

Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.

出版信息

Minerva Chir. 2020 Apr;75(2):72-76. doi: 10.23736/S0026-4733.18.07712-X. Epub 2018 Apr 13.

DOI:10.23736/S0026-4733.18.07712-X
PMID:29658677
Abstract

BACKGROUND

Obesity is a serious disease, with an increasing incidence also among subjects over 60 years old; surgical management has proven to be the most effective in the production of significant and durable weight loss. Intragastric balloon (IGB) treatment promotes a reduction of five to nine Body Mass Index (BMI) units in 6 months with an impressive improvement of obesity-associated comorbidities.

METHODS

Two hundred and twenty-five patients, 106 men (47.1%) and 119 women (52.9%), were evaluated at our institution to be submitted to a IGB positioning. Of these, 12 patients (8 women and 4 men) were more than 60 years old. For all patients BMI, comorbidities, weight loss and complications were recorded. χ2 test was used to evaluate differences in complications rate between elderly and other patients.

RESULTS

For the 12 elderly patients, we recorded a mean excess weight loss rate (EWL%) of 31.4. About complications, we recorded 2 severe esophagitis requiring IGB removal and 1 late gastric perforation. A higher complications rate was found in elderly population and the comparison with other patients revealed a significant difference (P<0.001).

CONCLUSIONS

Our results underline that IGB treatment in elderly patients is safe and effective in terms of weight loss and improvement in comorbidities. IGB can cause complications which, sometimes, can be severe such as esophageal damage and gastric perforation. For the management of complications, we highly recommend a close follow-up in all patients and a deepened instrumental study in every suspect case.

摘要

背景

肥胖是一种严重的疾病,发病率在 60 岁以上人群中也呈上升趋势;手术治疗已被证明是产生显著和持久体重减轻的最有效方法。胃内球囊(IGB)治疗在 6 个月内可使体重指数(BMI)降低 5 至 9 个单位,对肥胖相关合并症有显著改善作用。

方法

在我们的机构中,对 225 名患者(106 名男性[47.1%]和 119 名女性[52.9%])进行了评估,这些患者将接受 IGB 定位。其中,12 名患者(8 名女性和 4 名男性)年龄超过 60 岁。记录所有患者的 BMI、合并症、体重减轻和并发症。χ2 检验用于评估老年患者与其他患者并发症发生率的差异。

结果

对于 12 名老年患者,我们记录的平均超重减轻率(EWL%)为 31.4%。关于并发症,我们记录了 2 例严重食管炎需要取出 IGB 和 1 例晚期胃穿孔。老年患者的并发症发生率较高,与其他患者的比较显示差异有统计学意义(P<0.001)。

结论

我们的结果表明,IGB 治疗在老年患者中是安全有效的,可减轻体重和改善合并症。IGB 可引起并发症,有时甚至很严重,如食管损伤和胃穿孔。对于并发症的管理,我们强烈建议所有患者密切随访,并在每个疑似病例中进行深入的仪器检查。

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