Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
United European Gastroenterol J. 2020 Jul;8(6):685-694. doi: 10.1177/2050640620926837.
Obesity, type 2 diabetes mellitus (T2DM) and nonalcoholic steatohepatitis are increasing pandemic metabolic disorders. Lifestyle intervention (LSI) is the cornerstone treatment for these but is successful as standard care alone in only a few patients, given the modest weight loss at mid and long term. Conversely, bariatric surgery is the only proven effective treatment for these metabolic disorders, albeit offered only in a small percentage of cases because of its invasiveness and cost. The so-called (EBMTs) include new, less-invasive technologies such as intragastric balloons, aspiration therapy, endoscopic sleeve gastroplasty, diversion devices, and duodenal mucosal resurfacing, currently at various stages of development. EBMTs, as an add-on to LSI, might represent an effective treatment filling the gap between medical and surgical management, taking into account, however, that obesity and its associated comorbidities constitute a chronic disease that needs lifelong therapy. In this review we describe the current scientific evidence surrounding EBMTs as well as future opportunities for such treatments in managing obesity and metabolic disorders.
肥胖症、2 型糖尿病（T2DM）和非酒精性脂肪性肝炎是日益流行的代谢性疾病。生活方式干预（LSI）是这些疾病的基石治疗方法，但由于中、长期体重减轻幅度较小，仅对少数患者作为标准治疗成功。相反，减重手术是这些代谢性疾病唯一被证实有效的治疗方法，但由于其侵袭性和成本，仅在一小部分病例中提供。所谓的（EBMTs）包括新的、侵袭性较小的技术，如胃内球囊、抽吸疗法、内镜袖状胃成形术、分流装置和十二指肠黏膜再形成术，目前处于不同的发展阶段。EBMTs 作为 LSI 的附加治疗方法，可能是一种有效的治疗方法，可以填补医学和手术管理之间的空白，但需要考虑到肥胖症及其相关合并症构成一种需要终身治疗的慢性疾病。在这篇综述中，我们描述了围绕 EBMTs 的当前科学证据，以及这些治疗方法在管理肥胖症和代谢性疾病方面的未来机会。
