General Surgery Clinic, Private Beylikdüzü Kolan Hospital, Adnan Kahveci Mahallesi Osmanlı Caddesi No. 23, Beylikdüzü, 34582, Istanbul, Turkey.
Health Science and Administration College, Istanbul Gelişim University, Cihangir, Jandarma Komando Er, Cihangir Mahallesi Şehit Jandarma, J. Kom. Er Hakan Öner Sk. No. 1, Avcılar, 34310, Istanbul, Turkey.
Obes Surg. 2020 Sep;30(9):3365-3369. doi: 10.1007/s11695-020-04556-7.
To analyze how considering the structure of normotonic pylorus (NP) or hypotonic pylorus (HP) contributes to treatment success in patients administered gastric botulinum toxin A for weight loss.
We measured body mass indexes (BMIs) of the patients who applied for gastric botulinum toxin A (BTA) for weight loss, before and 6 months after the procedure. The patients' pylori were classified as normotonic pylorus (NP) if, during endoscopy, they had a normal peristaltic motion and was closing completely, and as hypotonic pylorus if they were not closing properly or were aperistaltic. We compared the patients' mean pre-operative and 6-month post-operative BMIs. The groups were compared using the chi-square test where a p ˂ 0.05 was considered significant.
The study included 178 patients administered gastric BTA. In the assessment made without considering the pyloric structure, the mean BMI decreased from 34.76 ± 7.65 to 33.09 ± 7.80 kg/m, while the difference was not statistically significant (p ˂ 0.06). Conversely, in the analysis performed considering the structure of pylorus, the mean pre-operative BMI of the 45 patients with HP structure was 35.16 ± 7.07 kg/m which decreased to 35.11 ± 7.03 kg/m 6 months after the procedure; hence, the difference was not statistically significant (p ˂ 0.7). The mean pre-operative BMI of the 133 patients with NP structure, 34.63 ± 7.84 kg/m, decreased to 32.40 ± 8.05 kg/m 6 months after the procedure and the difference was statistically significant (p ˂ 0.05)*.
We advise to be selective in BTA administration and to administer BTA to the patients who, endoscopically, have a NP structure.
分析在考虑正常张力幽门（NP）或低张力幽门（HP）结构的情况下，对接受胃内肉毒杆菌毒素 A 治疗减肥的患者的治疗成功率有何影响。
我们测量了因减肥而申请胃内肉毒杆菌毒素 A（BTA）的患者的体重指数（BMI），分别在治疗前和治疗后 6 个月进行测量。如果患者在胃镜检查时具有正常的蠕动运动并完全关闭，则将其幽门分类为正常张力幽门（NP），如果他们不能正常关闭或没有蠕动运动，则将其幽门分类为低张力幽门（HP）。我们比较了患者的平均术前和 6 个月后的 BMI。使用卡方检验比较两组，p 值小于 0.05 被认为具有统计学意义。
本研究共纳入 178 例接受胃内 BTA 治疗的患者。在不考虑幽门结构的评估中，平均 BMI 从 34.76 ± 7.65kg/m2 下降至 33.09 ± 7.80kg/m2，但差异无统计学意义（p ˂ 0.06）。相反，在考虑幽门结构的分析中，45 例 HP 结构患者的术前平均 BMI 为 35.16 ± 7.07kg/m2，治疗 6 个月后下降至 35.11 ± 7.03kg/m2，差异无统计学意义（p ˂ 0.7）。133 例 NP 结构患者的术前平均 BMI 为 34.63 ± 7.84kg/m2，治疗 6 个月后下降至 32.40 ± 8.05kg/m2，差异有统计学意义（p ˂ 0.05）。
我们建议在 BTA 给药时进行选择，并仅在胃镜下具有 NP 结构的患者中给予 BTA。
