Is bariatric surgery necessary after intragastric balloon treatment?
Is bariatric surgery necessary after intragastric balloon treatment?
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DOI：
10.1381/096089206778392365
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发表时间：
2006-09-01
期刊：
影响因子：
2.9
通讯作者：
Capece, Giuseppe
中科院分区：
文献类型：
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作者：
Angrisani, Luigi;Lorenzo, Michele;Capece, Giuseppe
背景：使用 Bio-Enterics 胃内气球 (BIB) 已被证明是暂时治疗病态肥胖的安全有效的方法。我们对 BIB 切除后接受减肥手术的患者和不想手术的患者的体重减轻进行了回顾性比较分析。方法：从 2000 年 1 月至 2004 年 3 月，175 名患者（104 F/71 M；平均年龄 37.1 +/- 11.6 岁，范围 16-67；平均 BMI 54.4 +/- 8.1）中放置了 182 个 BIBS。 kg/m(2)，范围 39.8-79.5；平均值 %EW 160.8 +/- 32.9% 范围 89-264)。因球囊破裂（n=2，1.1%）和心理不耐受（n=7，7.8%）而紧急移除 BIB 的患者被排除在本研究之外。所有患者在 BIB 定位之前均计划进行减肥手术。 BIB 切除后，许多患者现在拒绝手术。因此，患者被分为 2 组：A 组，去除 BIB 后进行减肥手术（Lap-Band (R)、腹腔镜胃绕道手术、十二指肠转接术）（n=86）； BIB 切除后拒绝任何手术的 B 组患者 (n=82)。两组患者均接受了至少 12 个月的随访。结果报告为平均 BMI 和 %EWL +/- SD。通过Student t 检验或Fisher 精确检验进行统计分析，P < 0.05 视为显着。 结果：166 名患者在移除时的平均 BMI 和平均 %EWL 分别为 47.3 +/- 8.1 kg/m(2) 和 32.1 +/- 16.6%。同时，A 组和 B 组的平均 BMI 分别为 47.6 +/- 6.9 和 48.1 +/- 6.5 kg/m(2) (P=NS)。 12 个月随访 (100%) 时，A 组（BIB + 手术）平均 BMI 为 35.1 kg/m(2)，B 组（单独 BIB）平均 BMI 为 51.7 kg/m(2)（P < 0.001）。结论：BIB 移除后，一半 (49.4%) 计划手术的患者拒绝减肥手术。这些患者在 12 个月的随访中恢复到平均初始体重。因此，强烈建议在 BIB 切除后进行减肥手术。
Background: The use of the Bio-Enterics intra-gastric balloon (BIB) has been shown to be a safe and effective procedure for the temporary treatment of morbid obesity. We conducted a retrospective comparative analysis of the weight loss in patients that after BIB removal underwent bariatric surgery and those who did not wish surgery.Methods: From January 2000 to March 2004, 182 BIBS were positioned in 175 patients (104 F/71 M; mean age 37.1 +/- 11.6 years, range 16-67; mean BMI 54.4 +/- 8.1 kg/m(2), range 39.8-79.5; mean %EW 160.8 +/- 32.9% range 89-264). Patients were excluded from this study who had emergency BIB removal for balloon rupture (n=2, 1.1%) and for psychological intolerance (n=7, 7.8%). All patients were scheduled for a bariatric operation, before BIB positioning. After BIB removal, a number of patients now declined surgery. Consequently, patients were allocated into 2 groups: Group A in whom BIB removal was followed by bariatric surgery (Lap-Band (R), laparoscopic gastric bypass, duodenal switch) (n=86); Group B patients who after BIB removal refused any surgical procedure (n=82). Both groups were followed for a minimum of 12 months. Results were reported as mean BMI and %EWL +/- SD. Statistical analysis was done by Student t-test or Fisher's exact test, with P < 0.05 considered significant.Results: Mean BMI and mean %EWL in the 166 patients at time of removal were 47.3 +/- 8.1 kg/m(2) and 32.1 +/- 16.6%, respectively. At the same time, mean BMI was 47.6 +/- 6.9 and 48.1 +/- 6.5 kg/m(2) in group A and B (P=NS). At 12 months follow-up (100%), mean BMI was 35.1 kg/m(2) in Group A (BIB + surgery) and 51.7 kg/m(2) in Group B (BIB alone) (P < 0.001).Conclusions: After BIB removal, half (49.4%) of the patients scheduled for surgery refused a bariatric operation. These patients returned to their mean initial weight at 12 months follow-up. Therefore, bariatric surgery after BIB removal is highly recommended.