Obezite tedavisinde intragastrik balon yöntemi güvenli ve etkili mi?

Öz

Amaç: Obezite tedavi yöntemlerinden bariatrik cerrahi, invazif ve maliyetli bir yaklaşım olup kalıcı yan etkilere sahipken, göreceli daha az maliyetli medikal tedavinin sistemik yan etkileri söz konusu olabilir. İntragastrik balon (IGB) uygulaması ise medikal tedavi ve bariatrik cerrahi arasında minimal invazif ve geçici bir yöntemdir. Bu çalışmanın amacı, IGB uygulamasının etkinliğini ve güvenliğini değerlendirmektir. 

Yöntemler: Çalışmaya 2015 – 2017 yılları arasında IGB tedavisi uygulanan 39 hasta dahil edildi. İşlem öncesi ve sonrası vücut kitle indeksi (VKİ), fazla kilonun kayıp oranı, balonun hastalar tafından tolere edilebilmesi ve gelişen komplikasyonlar değerlendirildi.

Bulgular: İşlem öncesi ortanca vücut kitle indeksi (VKİ) değeri 33.2 kg/m² olan 39 hastanın 33’ü (%84,6) kadındı. İşlemi tolere edemeyen 3 hastanın (%7,6) balonu 1., 5. ve 25. günlerde çıkarıldı. Tedavinin ortanca süresi 8 aydı (1 gün-17 ay). Balonları ilk 6 ayda çıkarılan hastalarda fazla kilonun kayıp oranı %22,8 iken, 6 aydan uzun kalanlarda bu oran %41,6 idi. Balon çıkarılması sonrası VKİ ortanca değeri 28.3 kg/m² olarak bulundu. Sadece bir hastada (%2,5) spontan IGB rüptürü ve balonun defekasyonla atılması görüldü.

Sonuç: IGB uygulaması başarısız diyet ve egzersiz denemeleri olan ve bariatrik cerrahi yapılmayacak hastalara güvenli ve etkili bir yöntem olarak önerilebilir.

Anahtar Kelimeler

• obezite,mide,balon,üreme,bariatrik

Intragastric balloon therapy for obesity: Is it safe and effective?

Abstract

Aim: Bariatric surgery is a costly and invasive method with permanent effects and medications for treatment of obesity is less costly but may cause systemic side effects. Intragastric balloon (IGB) therapy is a minimal invasive and temporary option between medical therapy and bariatric surgery. The aim of this study is to evaluate the safety and efficiency of intragastric balloon application and present our results.

Methods: 39 patients who underwent IGB therapy between 2015 and 2017 were included in the study. IGB was advanced into the stomach, and then the balloon was filled with saline and methylene blue solution. The patients were assessed by a nutritionist during the follow-up period and after balloon removal they were evaluated for results.

Results: Of 39 patients, 33 were female and the median body mass index (BMI) was 33.2 kg/m² before the procedure. Three patients (7.6%) could not tolerate the balloon; therefore balloon extraction was performed on the day 1, 5 and 25. Median duration of therapy was 8 months (1 day-17 months). While excessive weight loss (EWL) ratio was 22.8% in patients whose balloon was removed in 6 months, EWL ratio was 41.6% in patients whose balloon remained more than 6 months. The median BMI after balloon removal was 28.3 kg/m². The only complication was spontaneous IGB deflation and excretion transanally.

Conclusion: Intragastric balloon therapy may be recommended as a safe and effective option for the patients who have had failed attempts of diet and exercise and will not undergo bariatric surgery.

Keywords

• obesity,gastric,balloon,colonization,bariatric

Kaynakça

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