内镜袖状胃成形术治疗肥胖症：单中心经验及文献综述
Endoscopic Sleeve Gastroplasty for the Treatment of Obesity: A Single-Centre Experience and Literature Review.
作者信息
Fernicola Agostino, Palomba Giuseppe, Calogero Armando, Santangelo Michele, Salvucci Alessandro, Verlingieri Viviana, Scognamiglio Giuseppe
机构信息
Department of Clinical Medicine and Surgery, Division of Endoscopic Surgery, Azienda Ospedaliera Universitaria Federico II, Naples, ITA.
Department of Advanced Biomedical Sciences, Division of Emergency Surgery, Azienda Ospedaliera Universitaria Federico II, Naples, ITA.
出版信息
Cureus. 2024 Oct 8;16(10):e71064. doi: 10.7759/cureus.71064. eCollection 2024 Oct.
BACKGROUND
In the world, obesity is constantly increasing, and so are the types of medical and surgical therapies. However, to cope with the increase in costs associated with surgical procedures and certain complications, such as gastroesophageal reflux disease, the number of bariatric endoscopic (BE) procedures has been increasing in recent years. Endoscopic sleeve gastroplasty (ESG) is one of the most rapidly increasing BE procedures, given its benefits in terms of patient quality of life and reduced costs. In fact, it is a procedure characterised by minimal postoperative complications and is applicable to different types of bariatric patients. However, the number of studies on BE is not comparable to that on bariatric surgery.
METHODS
We analyzed the results of 84 ESG performed in our centre and compared them with those presented in the literature. We evaluated 36-Item Short Form Health Survey (SF-36) to 0, six and 13 months, signs and symptoms of patients undergoing ESG on the first and second postoperative day (POD), in terms of abdominal pain, nausea and vomiting. We found a reduction of these outcomes from POD 1 to POD 2. Finally, we measured total body weight loss percentage (TBWL%) and excess weight loss percentage (EWL%) at three, six and 12 months both in patients undergoing bariatric surgery for the first time (specifically, ESG) and in patients previously undergoing bariatric surgery and then undergoing ESG.
RESULTS
Using the SF-36 score, we observed an improvement in the physical (mean score from 46.4 at time 0 to 53.6 at 12 months from the ESG) and mental (mean score from 37 at time 0 to 39.9 at 12 months from the ESG) status of the patients. Furthermore, we observed a 0 to 12-month increase in TBWL% and EWL% from the ESG procedure. Furthermore, we observed an increase in TBWL% and EWL% at three, six and 12 months both in patients undergoing bariatric surgery for the first time (specifically ESG) and in patients previously undergoing bariatric surgery and then undergoing ESG.
CONCLUSION
ESG was an effective, reversible, and repeatable surgical procedure for bariatric patients.
背景
在全球范围内，肥胖率持续上升，医学和外科治疗方法的种类也在增加。然而，为了应对与手术程序及某些并发症（如胃食管反流病）相关的成本增加，近年来减重内镜手术（BE）的数量一直在增加。内镜下袖状胃成形术（ESG）是增长最为迅速的BE手术之一，因其对患者生活质量有益且成本降低。事实上，该手术的特点是术后并发症极少，适用于不同类型的肥胖患者。然而，关于BE的研究数量与减重手术的研究数量不可相提并论。
方法
我们分析了在我们中心进行的84例ESG手术的结果，并将其与文献中报道的结果进行比较。我们在术后第0、6和13个月评估了36项简短健康调查问卷（SF - 36），并在术后第1天和第2天评估了接受ESG手术患者的腹痛、恶心和呕吐等体征和症状。我们发现这些结果从术后第1天到第2天有所减轻。最后，我们测量了首次接受减重手术（具体为ESG）的患者以及先前接受过减重手术然后接受ESG的患者在3个月、6个月和12个月时的总体重减轻百分比（TBWL%）和超重减轻百分比（EWL%）。
结果
使用SF - 36评分，我们观察到患者的身体状况（ESG术后0个月时平均评分为46.4，12个月时为53.6）和精神状况（ESG术后0个月时平均评分为37，12个月时为39.9）有所改善。此外，我们观察到ESG手术使TBWL%和EWL%在0至12个月期间有所增加。此外，首次接受减重手术（具体为ESG）的患者以及先前接受过减重手术然后接受ESG的患者在3个月、6个月和12个月时的TBWL%和EWL%均有所增加。
结论
ESG对于肥胖患者是一种有效、可逆且可重复的手术方法。
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