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胃内球囊放置术在等待肾移植的透析患者中的疗效和安全性。

Efficacy and Safety of Intra-gastric Balloon Placement in Dialyzed Patients Awaiting Kidney Transplantation.

机构信息

Department of Nephrology Dialysis, Transplantation, IFRNT, University of Paris-Sud, Le Kremlin Bicetre, France.

INSERM UMRS1197, Villejuif, France.

出版信息

Obes Surg. 2019 Feb;29(2):713-720. doi: 10.1007/s11695-018-3574-4.

Abstract

BACKGROUND

The number of obese patients who are candidates for renal transplantation has considerably increased, but obesity can be a barrier to kidney transplantation. Weight loss is often difficult through diet alone. We studied the efficacy and tolerance of the intra-gastric balloon (IGB) procedure in obese patients who were undergoing dialysis and were candidates for a renal transplantation.

PATIENTS AND METHODS

Obese patients (BMI > 30 kg/m) who were candidates for renal transplantation were prospectively included in the study between 2010 and 2012. The balloon was inserted and removed during a gastric endoscopy under general anesthesia. The treatment lasted 6 months. The end point was a decrease in BMI after 6 months. Body impedance spectrometry (BIS) and nutritional statute were evaluated initially and then after IGB removal.

RESULTS

Seventeen patients (nine females and eight males) with a mean age of 53.4 years [19.4-69.4] were included. The decrease in body mass index (BMI) during the 6-month placement was 3 kg/m (from 37.7 to 34.4 kg/m). The mean weight loss was 7 kg. The mean percentage of excess weight loss after 6 months was 20.2 (± 11.4). The tolerance was good without any complications. Eleven patients underwent kidney transplantation.

CONCLUSION

IGB in obese dialyzed patients who are candidates for renal transplantation is safe and effective. However, the amount of weight loss can vary.

摘要

背景

肥胖患者作为肾移植候选者的数量显著增加,但肥胖可能成为肾移植的障碍。仅通过饮食减肥通常较为困难。我们研究了胃内球囊(IGB)程序在接受透析和准备接受肾移植的肥胖患者中的疗效和耐受性。

患者和方法

2010 年至 2012 年间,前瞻性纳入了肥胖(BMI>30kg/m)且适合肾移植的患者。球囊在全身麻醉下通过胃镜插入和取出。治疗持续 6 个月。终点是 6 个月后 BMI 的下降。最初和 IGB 去除后评估身体阻抗谱(BIS)和营养状况。

结果

共纳入 17 例患者(9 名女性和 8 名男性),平均年龄为 53.4 岁[19.4-69.4]。6 个月期间的体重指数(BMI)下降 3kg/m(从 37.7 降至 34.4kg/m)。平均体重减轻 7kg。6 个月后多余体重减轻的平均百分比为 20.2(±11.4)。耐受性良好,无任何并发症。11 例患者接受了肾移植。

结论

IGB 对于接受透析且适合肾移植的肥胖患者是安全有效的。然而,体重减轻的量可能有所不同。

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