Abbitt Danielle, Choy Kevin, Kovar Alexandra, Jones Teresa S, Wikiel Krzysztof J, Jones Edward L
Department of Surgery, University of Colorado, Aurora, CO 80045, United States.
Department of Surgery, Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO 80045, United States.
World J Gastrointest Surg. 2024 Jul 27;16(7):2040-2046. doi: 10.4240/wjgs.v16.i7.2040.
Over one-third of Americans carry the diagnosis of obesity, many also with obesity-related comorbidities. This can place patients at increased risk of operative and postoperative complications. The intragastric balloon has been shown to aid in minor weight loss, however its weight recidivism in patients requiring short interval weight loss has not been well studied.
To evaluate weight loss, ability to undergo successful elective surgery after intragastric balloon placement, and weight management after balloon removal.
This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective surgery. Clinical outcomes including weight loss, duration of balloon placement, successful elective surgery, weight regain post-balloon and post-procedure complications were assessed. Exclusion criteria included those with balloon in place at time of study.
Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective surgery. All patients were required to participate in a 12-month weight management program to be eligible for balloon therapy. Elective surgeries included incisional hernia repair, umbilical hernia repair, inguinal hernia repair, and knee and hip replacements. The average age at placement was 53 years ± 11 years, majority (91%) were male. The average duration of intragastric balloon therapy was 186 days ± 41 days. The average weight loss was 14.0 kg ± 7.4 kg and with an average percent excess body weight loss of 30.0% (7.9%-73.6%). Over half of the patients (52.0%) achieved the goal of 30-50 lbs (14-22 kg) weight loss. Twenty-one patients (64%) underwent their intended elective surgery, 2 patients (6%) deferred surgery due to symptom relief with weight loss alone. Twenty-one of the patients (64%) have documented weights in 3 months after balloon removal, in these patients the majority (76%) gained weight after balloon removed. In patients with weight regain at 3 months, they averaged 5.8 kg after balloon removal in the first 3 months, this averaged 58.4% weight regain of the initial weight lost.
Intragastric balloon placement is an option for short-term weight management, as a bridge to elective surgery in patients with body mass index (BMI) > 35. Patients lost an average of 14 kg with the balloon, allowing two-thirds of patients to undergo elective surgery at a healthy BMI. However, most patients regained an average of 58% of the original weight lost after balloon removal. The intragastric balloon successfully serves as a tool for rapid weight loss, though patients must be educated on the risks including weight regain.
超过三分之一的美国人被诊断为肥胖，许多人还伴有肥胖相关的合并症。这会使患者手术及术后并发症的风险增加。胃内球囊已被证明有助于小幅减重，然而，对于需要短期内减重的患者，其体重复发情况尚未得到充分研究。
评估胃内球囊置入后的体重减轻情况、成功接受择期手术的能力以及球囊取出后的体重管理情况。
本研究是对一家学术机构中2019年至2023年接受胃内球囊置入以辅助减重以便进行择期手术的患者进行的回顾性研究。评估了包括体重减轻、球囊置入持续时间、成功的择期手术、球囊取出后体重反弹及术后并发症等临床结局。排除标准包括研究时球囊仍在位的患者。
2019年至2023年期间，33例患者完成了胃内球囊治疗作为择期手术的桥梁。所有患者均需参加为期12个月的体重管理计划才有资格接受球囊治疗。择期手术包括切口疝修补术、脐疝修补术、腹股沟疝修补术以及膝关节和髋关节置换术。置入球囊时的平均年龄为53岁±11岁，大多数（91%）为男性。胃内球囊治疗的平均持续时间为186天±41天。平均体重减轻14.0千克±7.4千克，平均超重体重减轻百分比为30.0%（7.9%-73.6%）。超过半数患者（52.0%）实现了减重30-50磅（14-22千克）的目标。21例患者（64%）接受了预期的择期手术，2例患者（6%）因仅通过减重症状缓解而推迟手术。21例患者（该文本此处重复，推测有误，应为21例患者（64%））在球囊取出后3个月有体重记录，在这些患者中，大多数（76%）在球囊取出后体重增加。在3个月时体重反弹的患者中，球囊取出后的前3个月平均体重增加5.8千克，这平均为最初减轻体重的58.4%。
对于体重指数（BMI）>35的患者，胃内球囊置入是短期体重管理的一种选择，可作为择期手术的桥梁。使用球囊时患者平均减重14千克，使三分之二的患者能够在健康的BMI水平下接受择期手术。然而，大多数患者在球囊取出后平均恢复了最初减轻体重的58%。胃内球囊成功地作为快速减重的工具，不过必须让患者了解包括体重反弹在内的风险。
