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减重内镜检查的现状——外科医生需要了解什么?一篇综述。

Status of bariatric endoscopy-what does the surgeon need to know? A review.

作者信息

de Moura Diogo Turiani Hourneaux, Dantas Anna Carolina Batista, Ribeiro Igor Braga, McCarty Thomas R, Takeda Flávio Roberto, Santo Marco Aurelio, Nahas Sergio Carlos, de Moura Eduardo Guimarães Hourneaux

机构信息

Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de Sao Paulo, Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP, Sao Paulo 05403-010, Brazil.

Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Unidade de Cirurgia Bariátrica e Metabólica, Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Sao Paulo 05403-010, Brazil.

出版信息

World J Gastrointest Surg. 2022 Feb 27;14(2):185-199. doi: 10.4240/wjgs.v14.i2.185.

Abstract

BACKGROUND

Obesity is a chronic and multifactorial disease with a variety of potential treatment options available. Currently, there are several multidisciplinary therapeutic options for its management, including conservative, endoscopic, and surgical treatment.

AIM

To clarify indications, technical aspects, and outcomes of bariatric endoscopy.

METHODS

Narrative review of current literature based on electronic databases including MEDLINE (PubMed), Cochrane Library, and SciELO.

RESULTS

Bariatric endoscopy is in constant development and comprises primary and revisional treatment options as well as management of surgical complications. Various devices act upon different mechanisms of action, which may be individualized to each patient. Despite favorable results for the endoscopic treatment of obesity, prospective randomized studies with long-term follow-up are required to fully validate primary and revisional endoscopic therapies. Regarding the management of bariatric surgery complications, endoscopic therapy may be considered the procedure of choice in a variety of situations. Still, as there is no standardized algorithm, local experience should be considered in decision-making.

CONCLUSION

The treatment of patients with obesity is complex, and a multidisciplinary approach is essential. Bariatric endoscopy has shown impressive results both in the treatment of obesity and its surgical complications, and therefore, must be part of the armamentarium in the fight against this disease.

摘要

背景

肥胖是一种慢性多因素疾病,有多种潜在的治疗选择。目前,其管理有几种多学科治疗选择,包括保守治疗、内镜治疗和手术治疗。

目的

阐明减重内镜检查的适应症、技术方面和结果。

方法

基于电子数据库(包括MEDLINE(PubMed)、Cochrane图书馆和SciELO)对当前文献进行叙述性综述。

结果

减重内镜检查在不断发展,包括初次治疗和修正治疗选择以及手术并发症的管理。各种设备作用于不同的作用机制,可根据每个患者进行个体化。尽管内镜治疗肥胖取得了良好效果,但仍需要长期随访的前瞻性随机研究来充分验证初次和修正内镜治疗。关于减重手术并发症的管理,在各种情况下内镜治疗可被视为首选方法。然而,由于没有标准化算法,决策时应考虑当地经验。

结论

肥胖患者的治疗很复杂,多学科方法至关重要。减重内镜检查在肥胖治疗及其手术并发症方面都显示出了令人印象深刻的结果,因此,必须成为对抗这种疾病的手段之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db6c/8908340/46eb4009551c/WJGS-14-185-g001.jpg

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