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内镜减重治疗的现状。

Current State of Endoscopic Bariatric Therapies.

机构信息

Department of Surgery, Yale School of Medicine, PO Box 208062, New Haven, CT 06520, USA.

Department of Gastroenterology, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.

出版信息

Surg Clin North Am. 2025 Feb;105(1):159-171. doi: 10.1016/j.suc.2024.06.012. Epub 2024 Aug 1.

Abstract

The obesity epidemic poses a significant global health challenge. Despite proven efficacy, accessibility to bariatric surgery is limited. Endoscopic bariatric therapies offer less invasive alternatives. Reversible space-occupying devices like intragastric balloons are suitable for both primary obesity treatment and bridging to surgery. Restrictive therapies that reduce gastric volume like the primary obesity surgery endoluminal and endoscopic sleeve gastroplasty have shown promising short-term results. Diverting devices such as intestinal liners/barriers or magnet-assisted anastomoses aim to replicate surgical effects with lower risks, though efficacy varies. Finally, endoscopic revisional procedures like transoral outlet reduction address weight regain post-bariatric surgery.

摘要

肥胖症的流行是一个重大的全球健康挑战。尽管减重手术的疗效已得到证实,但它的可及性有限。内镜减重治疗提供了创伤更小的选择。胃内球囊等可逆的占位性装置既适用于原发性肥胖症的治疗,也适用于桥接手术。限制胃容量的治疗方法,如原发性肥胖症的内镜和内镜袖状胃成形术,已经显示出有前景的短期效果。肠道衬垫/屏障或磁辅助吻合等分流装置旨在用更低的风险复制手术效果,但疗效有所不同。最后,经口入路减少术等内镜翻修手术可以解决减重手术后体重反弹的问题。

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