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内镜袖状胃成形术的安全性概况——对222例连续患者(包括学习曲线阶段)进行的单中心回顾性分析

Endoscopic sleeve gastroplasty safety profile - retrospective, single-center analysis of 222 consecutive patients including the learning curve period.

作者信息

Kasprzyk Przemysław, Wysocka-Konieczna Kamila, Sobczak Matylda, Spychalski Michał

机构信息

Center of Bowel Treatment, Brzeziny, Poland.

Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Jun;19(2):243-248. doi: 10.5114/wiitm.2024.139687. Epub 2024 May 15.

Abstract

INTRODUCTION

The global obesity epidemic affects over 1.9 billion adults, with an additional 650 million classified as obese. Endoscopic sleeve gastroplasty (ESG) is a type of minimally invasive endobariatric procedure. It is a less invasive alternative to laparoscopic sleeve gastrectomy (LSG). Although the effectiveness of ESG is lower, it might have a better safety profile.

AIM

To assess the safety profile of ESG and describe complications classified as grade II or higher, using the Clavien-Dindo classification, with an overview of the learning curve.

MATERIAL AND METHODS

We included 222 patients who underwent ESG at the Endoscopic and Bariatric Surgery Center of the hospital in Brzeziny from January 2021 to October 2023. The severity of complications was evaluated based on the Clavien-Dindo classification, considering complications of grade II or higher.

RESULTS

Among the studied group of patients, a total of 4 (1.8%) cases of perioperative bleeding into the gastrointestinal tract were recorded. One (0.5%) patient had the most severe grade IVb complication that required treatment in the Intensive Care Unit. All patients with serious adverse events (SAE) fully recovered. We did not observe an association between the learning curve, procedure duration, and the frequency or severity of postoperative complications.

CONCLUSIONS

The presented results confirm the high safety of ESG in the treatment of obesity.

摘要

引言

全球肥胖流行影响着超过19亿成年人,另有6.5亿人被归类为肥胖。内镜下袖状胃成形术(ESG)是一种微创减重手术。它是腹腔镜袖状胃切除术(LSG)侵入性较小的替代方法。尽管ESG的有效性较低,但它可能具有更好的安全性。

目的

使用Clavien-Dindo分类法评估ESG的安全性,并描述分类为II级或更高等级的并发症,同时概述学习曲线。

材料与方法

我们纳入了2021年1月至2023年10月在布热济尼医院内镜与减重手术中心接受ESG的222例患者。根据Clavien-Dindo分类法评估并发症的严重程度,考虑II级或更高等级的并发症。

结果

在研究的患者组中,共记录到4例(1.8%)围手术期胃肠道出血病例。1例(0.5%)患者出现最严重的IVb级并发症,需要在重症监护病房接受治疗。所有发生严重不良事件(SAE)的患者均完全康复。我们未观察到学习曲线、手术持续时间与术后并发症的频率或严重程度之间存在关联。

结论

所呈现的结果证实了ESG在肥胖治疗中的高安全性。

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