Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168, Rome, Italy.
Centre for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Obes Surg. 2022 Oct;32(10):3390-3397. doi: 10.1007/s11695-022-06232-4. Epub 2022 Aug 2.
With the aging of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short- and medium-term outcomes of ESG in patients with obesity aged 65 years and older.
A retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, and the presence of comorbidities were assessed.
Eighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m. After ESG, the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12, and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12, and 24 months, respectively. The median BAROS score was 3.0, 3.4, and 2.5 at 6, 12, and 24 months, respectively. Six out of twelve patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. Two out of six patients with OSA stopped therapy with CPAP. No adverse events were recorded.
According to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suitable for bariatric surgery because of age and comorbidities.
随着人口老龄化和肥胖症的流行，肥胖的老年人的频率稳步增长。迄今为止，尚无评估内镜袖状胃切除术（ESG）在老年人中应用的数据。在本病例系列中，我们评估了年龄在 65 岁及以上的肥胖患者行 ESG 的短期和中期效果。
对前瞻性数据库进行回顾性分析；将年龄在 65 岁及以上的患者纳入我们的分析。评估了体重减轻百分比（EWL%）、总体重减轻百分比（TBWL%）、肥胖分析和报告结果系统（BAROS）问卷和并存疾病的存在情况。
18 名年龄在 65 岁及以上的患者于 2017 年 11 月至 2021 年 7 月期间接受了 ESG。中位年龄为 67 岁，平均基线 BMI 为 41.2kg/m2。ESG 后 6、12 和 24 个月时，TBWL%的中位数分别为 15.1%、15.5%和 15.5%，而 EWL%的中位数分别为 39%、37%和 41%。BAROS 评分的中位数分别为 6、12 和 24 个月时的 3.0、3.4 和 2.5。ESG 后 12 个月内，12 例高血压患者中有 6 例和 4 例糖尿病患者中的 3 例减少或停用了药物。6 例阻塞性睡眠呼吸暂停（OSA）患者中有 2 例停止了 CPAP 治疗。未记录到不良事件。
根据我们的经验，对于因年龄和并存疾病而拒绝或不适合接受减肥手术的非侵入性方法失败的肥胖老年患者，ESG 是一种有前途的治疗选择。
