针对小肠的减肥和代谢疗法。
Bariatric and Metabolic Therapies Targeting the Small Intestine.
作者信息
McCarty Thomas R, Thompson Christopher C
机构信息
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, USA.
Harvard Medical School, Boston, MA 02115, USA.
出版信息
Tech Innov Gastrointest Endosc. 2020 Jul;22(3):145-153. doi: 10.1016/j.tige.2020.03.008. Epub 2020 Jun 24.
The global prevalence of obesity and type 2 diabetes (T2DM) necessitates an increased reliance on effective and safe endoscopic therapies. While surgery is highly effective, endoscopic therapies may be able to reach a greater number of affected individuals and help to reduce the burden of disease worldwide. Although current endoscopic treatments entail space occupying gastric devices as well as suturing or plication, innovative, non-Food and Drug Administration (FDA) approved small bowel specific endoscopic bariatric and metabolic therapies have been developed within the last several years. Small intestine therapies include endoluminal bypass liners, duodenal mucosal resurfacing, endoscopic anastomosis systems, and restricted duodenal flow treatments. These endoscopic bariatric and metabolic therapies rely upon foregut and hindgut mechanisms to achieve weight loss and improve glucose homeostasis. This review will detail these important small bowel mechanisms and evaluates current small bowel endoscopic treatments.
全球肥胖症和2型糖尿病（T2DM）的流行使得人们越来越依赖有效且安全的内镜治疗。虽然手术非常有效，但内镜治疗或许能够惠及更多的患者，并有助于减轻全球的疾病负担。尽管目前的内镜治疗需要使用占据空间的胃部装置以及缝合或折叠技术，但在过去几年中，已经开发出了一些创新的、未经美国食品药品监督管理局（FDA）批准的针对小肠的内镜减肥和代谢疗法。小肠治疗方法包括腔内旁路衬垫、十二指肠黏膜重塑、内镜吻合系统以及限制十二指肠血流治疗。这些内镜减肥和代谢疗法依靠前肠和后肠机制来实现体重减轻并改善葡萄糖稳态。本综述将详细介绍这些重要的小肠机制，并评估当前的小肠内镜治疗方法。
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