Laparoskopik sleeve gastrektomi ve intragastrik balon uygulaması: Morbid obes hastalarda erken dönem sonuçlarımız

Öz

Amaç: Morbid obes hastalarda kilo verilmesi için endoskopik intragastrik balon uygulaması (İGB) ve bariatrik cerrahi yöntemlerinden biri olan laparoskopik sleeve gastrektomi (LSG) yaygın olarak kullanılmaktadır. Çalışmamızda morbid obes hastalarda LSG ve İGB uygulanması sonuçlarımızın değerlendirilmesi amaçlanmıştır.

Yöntemler: Morbid Obesite (Vücut Kitle İndeksi-VKİ ≥40 kg/m2) nedeniyle aynı dönemde tedavi edilen ve 12 aylık takip dönemini tamamlayan 119 hastanın verileri retrospektif olarak değerlendirildi. Çalışmada İGB uygulanan 20 hasta ve LSG yapılan 99 hasta yer aldı. Hastaların demografik verileri, yandaş hastalık, preoperatif ve postoperatif 12. ayda kilo ve VKİ verileri, verilen fazla kilo ve yüzdeleri, verilen fazla VKİ ve yüzdeleri kaydedilip gruplar karşılaştırıldı.

Bulgular: LSG ve İGB grupları arasında preoperatif kilo açısından istatiksel anlamlı farklılık olduğu görüldü (sırasıyla 124,3 ± 17 ve 145,5 ± 24,7; p<0,001). Postoperatif 12. ayda ölçülen kilo değerlendirildiğinde İGB grubunda ortalama 119,2 ±28,5 kg ve LSG grubunda 78,9 ± 12,9 kg saptandı (p<0,001). İGB grubundaki hastaların 12.ay sonunda ortalama 26,3 ±12,8 kg kilo verdiği, LSG grubundaki hastalarında 45,35 ±12,2 kg kilo verdiği görüldü (p<0,001). Postoperatif 12. ayda saptanan verilen fazla kilo yüzdesi İGB grubunda 33,42 ±9,2%, LSG grubunda 67,68 ±14,9% saptandı (p‹0,001). Postoperatif 12.ayda saptanan verilen fazla VKİ yüzdesi açısından İGB grubunda 41 ±17,3%, LSG grubunda 81,48  ±18,8% saptandı (p<0,001).

Sonuç: Morbid obes hastalarda endoskopik İGB uygulaması cerrahiye uygun olmayan veya cerrahi tedaviyi tercih etmeyen hastalarda etkin ve güvenli bir tedavi seçeneği olarak tercih edilebilir. 

Anahtar Kelimeler

• Morbid obesite,laparoskopik sleeve gastrektomi

Laparoscopic sleeve gastrectomy versus endoscopical intra-gastric balloon placement: early results of morbidly obese patients

Abstract

Aim: Endoscopic intra-gastric balloon (IGB) placement and laparoscopic sleeve gastrectomy (LSG) are widely used treatment modalities for weight loss in patients with morbid obesity. The aim of our study was to evaluate the results of these two methods in patients with morbid obesity.

Material and Methods: The data of 119 patients who were treated during the same time period for morbid obesity (Body Mass Index (BMI) ≥40 kg/m2) and completed a 12-month follow-up period were evaluated retrospectively. The study comprised twenty patients who underwent IGB placement and 99 LSG patients. Patients from these two groups were compared according to their demographic data; rate of comorbidity; weight and BMI changes both preoperatively and postoperatively at the 12 months; excess weight loss (EWL); and excess BMI loss (EBL).

Results: Evaluation of postoperative 12th month weights showed a mean weight of 119.2 ±28.5 kg in the IGB group and 78.9 ±12.9 kg in the LSG group (p<0.001). The patients in the IGB group had lost 26.3 ±12.8 kg by the end of the 12th month, while patients in the LSG group had lost 45.35 ±12.2 kg (p<0.001). EWL recorded at the postoperative 12th month was 33.42 ±9.2 % in the IGB group and 67.68 ±14.9 % in the LSG group (p<0.001); EBL% at the postoperative 12th month was 41 ±17.3% in the IGB group and 81.48 ±18.8% in the LSG group (p<0.001). 

Conclusion: In patients with morbid obesity, endoscopic IGB placement may still be preferred as an effective and safe alternative in patients who decline or are unsuitable for surgery.

Keywords

• Morbid obesity,laparoscopic sleeve gastrectomy

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