Gollisch Katja Susanne Claudia, Raddatz Dirk
Department of Gastroenterology and Gastrointestinal Oncology, Endocrine Unit, University Medical Center Göttingen, Göttingen, Germany.
Ann Transl Med. 2020 Mar;8(Suppl 1):S8. doi: 10.21037/atm.2019.09.67.
Worldwide, the prevalence of obesity has doubled since 1980 in 70 countries. More than one in three adults now suffer from overweight or obesity. Health problems related to obesity include orthopedic problems, psychiatric conditions, metabolic and cardiovascular diseases, and of increasing concern, cancer. Thus, obesity has an enormous impact on the individual's wellbeing as well as on society's workforce and health care expenses. Medical efforts are ongoing to find safe and effective treatment options for obesity and its metabolic implications. At present, available treatment options include lifestyle interventions, pharmacotherapy, endoscopic applications, and bariatric surgery. Within the range of endoscopic treatment options, the intragastric balloon is the most widely used device. The idea is simple: the gastric volume is reduced by a balloon that is in most cases implanted by an endoscopic procedure similar to a gastroscopy. During the past decades, different models have been developed, which we will briefly introduce in this review. We aim at reviewing the pathophysiology underlying the effect of endoscopic intragastric balloon on weight loss and metabolic changes. We will assess expected short-term and long-term benefits for the patient, and we will discuss common side effects as well as rare complications. We will compare endoscopic intragastric balloon to conservative treatment options with or without pharmacological support on the one hand and to the spectrum of bariatric surgery on the other hand. In most patients, obesity must be considered a chronic disease that requires a lifelong treatment concept. In view of current treatment options for obesity, we will discuss whether endoscopic intragastric balloon is a viable treatment option, and who may be the right patient to benefit from it.
在全球范围内，自1980年以来，70个国家的肥胖患病率翻了一番。现在，超过三分之一的成年人患有超重或肥胖症。与肥胖相关的健康问题包括骨科问题、精神疾病、代谢和心血管疾病，以及越来越受关注的癌症。因此，肥胖对个人健康以及社会劳动力和医疗费用都产生了巨大影响。医学领域正在不断努力寻找安全有效的肥胖症及其代谢影响的治疗方案。目前，可用的治疗方案包括生活方式干预、药物治疗、内镜应用和减肥手术。在内镜治疗方案范围内，胃内球囊是使用最广泛的装置。其原理很简单：通过一个球囊来减少胃容量，在大多数情况下，该球囊通过类似于胃镜检查的内镜手术植入。在过去几十年中，已经开发出了不同的型号，我们将在本综述中简要介绍。我们旨在综述内镜胃内球囊对体重减轻和代谢变化影响的病理生理学。我们将评估对患者预期的短期和长期益处，并讨论常见的副作用以及罕见的并发症。我们将一方面把内镜胃内球囊与有无药物支持的保守治疗方案进行比较，另一方面与减肥手术的范围进行比较。在大多数患者中，肥胖必须被视为一种需要终身治疗理念的慢性疾病。鉴于目前肥胖症的治疗方案，我们将讨论内镜胃内球囊是否是一种可行的治疗选择，以及谁可能是受益于此的合适患者。
