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İntragastrik Balon ve Botulinum Toksin Enjeksiyonunun Kilo Kaybı Üzerine Kısa Dönem Etkilerinin Karşılaştırılması

Yıl 2022, Cilt: 7 Sayı: 3, 51 - 55, 26.12.2022
https://doi.org/10.25000/acem.1168617

Öz

Amaç: Morbid obez olmayan hastalarda endoskopik intragastrik balon (IGB) yerleştirme ve intragastrik botulinum toksin-A (BTX-A) enjeksiyonunun kilo kaybı açısından etkilerini karşılaştırmak.
Yöntemler: Bu retrospektif tek merkezli çalışma 01.08.2020 ile 01.01.2022 tarihleri arasında gerçekleştirildi. Beden kitle indeksi (BKİ) <40 olan ve komorbiditesi olmayan toplam 39 hasta çalışmaya dahil edildi. Olguların 19'una intragastrik BTX-A enjeksiyonu ve 20'sine IGB yerleştirmesi yapıldı. Hastalar işlemlerden 1 ay ve 6 ay sonra değerlendirildi.
Bulgular: Ortalama yaş BTX-A grubunda 39.4 ± 8.6 ve IGB grubunda 37.3 ± 10.4 idi (p = 0.496). BTX-A grubunun %78,9'u ve IGB grubunun %75,0'ı kadındı (p = 1.000). Her iki grupta da işlem öncesi ile karşılaştırıldığında işlemden 1 ay sonra ve işlemden 1 ay sonrası ile karşılaştırıldığında işlemden 6 ay sonra ortanca ağırlık anlamlı düzeyde azaldı (her iki grup için p<0,001). BTX-A grubu ile karşılaştırıldığında hem 1. hem de 6. ayda medyan kilo kaybı IGB grubunda anlamlı düzeyde daha fazlaydı (her ikisi için p < 0,001).
Sonuç: Çalışmamızda müdahale sonrası 1. ve 6. ayda kilo kaybı ile ölçüldüğü üzere, IGB yerleştirilmesi intragastrik BTX-A enjeksiyonundan daha başarılı bir endoskopik bariatrik prosedür gibi görünmektedir. Obezite ile ilişkili komorbiditesi olmayan BKİ 40'ın altında olan hastalarda IGB tercih edilebilir.

Kaynakça

  • References 1. Stavrou G, Shrewsbury A, Kotzampassi K. Six intragastric balloons: Which to choose? World J Gastrointest Endosc. 2021;13:238-59.
  • 2. Bustamante F, Brunaldi VO, Bernardo WM, De Moura DTH, De Moura ETH, Galvão M, et al. Obesity treatment with botulinum toxin-A is not effective: a systematic review and meta-analysis. Obes Surg. 2017;27:2716-23.
  • 3. Emile SH, Mahdy T, Schou C, Kramer M, Shikora S. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg. 2021;92:106024.
  • 4. Ball W, Raza SS, Loy J, Riera M, Pattar J, Adjepong S, et al. Effectiveness of ıntra-gastric balloon as a bridge to definitive surgery in the super obese. Obes Surg. 2019;29:1932-6.
  • 5. Barrichello S, Badurdeen D, Hedjoudje A, Neto MG, Yance R, Veinert A, et al. The effect of the ıntra-gastric balloon on gastric emptying and the demeester score. Obes Surg. 2020;30:38-45.
  • 6. Behary J, Kumbhari V. Advances in the endoscopic management of obesity. Gastroenterol Res Pract. 2015;2015:757821.
  • 7. Bang CS, Baik GH, Shin IS, Kim JB, Suk KT, Yoon JH, et al. Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression. Gastrointest Endosc. 2015;81:1141-9. e7.
  • 8. De Castro ML, Morales MJ, Martínez-Olmos MA, Pineda JR, Cid L, Estévez P, et al. Safety and effectiveness of gastric balloons associated with hypocaloric diet for the treatment of obesity. Rev Esp Enferm Dig. 2013;105:529-36.
  • 9. Trang J, Lee SS, Miller A, Cruz Pico CX, Postoev A, Ibikunle I, et al. Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients - A systematic review and meta-analysis. Int J Surg. 2018;57:22-9.
  • 10. Barrichello Junior SA, Ribeiro IB, Fittipaldi-Fernandez RJ, Hoff AC, De Moura DTH, Minata MK, et al. Exclusively endoscopic approach to treating gastric perforation caused by an intragastric balloon: case series and literature review. Endosc Int Open. 2018;6:E1322-e9.
  • 11. Zheng Y, Wang M, He S, Ji G. Short-term effects of intragastric balloon in association with conservative therapy on weight loss: a meta-analysis. J Transl Med. 2015;13:246.
  • 12. Genco A, Cipriano M, Bacci V, Cuzzolaro M, Materia A, Raparelli L, et al. BioEnterics Intragastric Balloon (BIB): a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes (Lond). 2006;30:129-33.
  • 13. Ashrafian H, Monnich M, Braby TS, Smellie J, Bonanomi G, Efthimiou E. Intragastric balloon outcomes in super-obesity: a 16-year city center hospital series. Surg Obes Relat Dis. 2018;14:1691-9.
  • 14. Telem DA, Ghaferi AA. Gastric Balloons for Weight Loss in 2020. JAMA. 2020;324:2206-7.
  • 15. Saber AA, Shoar S, Almadani MW, Zundel N, Alkuwari MJ, Bashah MM, et al. Efficacy of first-time ıntragastric balloon in weight loss: A systematic review and meta-analysis of randomized controlled trials. Obes Surg. 2017;27:277-87.
  • 16. Peeters TL. Potential of ghrelin as a therapeutic approach for gastrointestinal motility disorders. Curr Opin Pharmacol. 2006;6:553-8.
  • 17. Foschi D, Corsi F, Lazzaroni M, Sangaletti O, Riva P, La Tartara G, et al. Treatment of morbid obesity by intraparietogastric administration of botulinum toxin: a randomized, double-blind, controlled study. Int J Obes. 2007;31:707-12.
  • 18. Topazian M, Camilleri M, Enders FT, Clain JE, Gleeson FC, Levy MJ, et al. Gastric antral injections of botulinum toxin delay gastric emptying but do not reduce body weight. Clin Gastroenterol Hepatol. 2013;11:145-50. e1.
  • 19. Durmus A, Durmus I, Akbas H, Tinkir NS. A456 The efficacy of ıntragastric balloon versus botulinum toxin ınjection ın obese patients. Surg Obes Relat Dis. 2019;15:S187-S8.
  • 20. Kanlioz M, Ekici U, Tatli F, Karatas T. Efficacy of intragastric balloon placement and botulinum toxin injection in bariatric endoscopy. Surg Laparosc Endosc Percutan Tech. 2020;30:500-3.
  • 21. Vargas EJ, Bazerbachi F, Calderon G, Prokop LJ, Gomez V, Murad MH, et al. Changes in time of gastric emptying after surgical and endoscopic bariatrics and weight loss: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2020;18:57-68. e5.
  • 22. Kakarla VR, Nandipati K, Lalla M, Castro A, Merola S. Are laparoscopic bariatric procedures safe in superobese (BMI ≥50 kg/m2) patients? An NSQIP data analysis. Surg Obes Relat Dis. 2011;7:452-8.
  • 23. Ribeiro IB, Gestic MA, Utrini MP, Chaim FDM, Chaim EA, Cazzo E. Drain amylase levels may indicate gastrojejunostomy leaks after roux-en-y gastric bypass. Arq Gastroenterol. 2018;55:66-72.
  • 24. Charalambous MP, Thompson J, Efthimiou E. Late gastric perforation after insertion of intragastric balloon for weight loss--video case report and literature review. Surg Obes Relat Dis. 2012;8:121-3.
  • 25. Al-Subaie S, Al-Barjas H, Al-Sabah S, Al-Helal S, Alfakharani A, Termos S. Laparoscopic management of a small bowel obstruction secondary to Elipse intragastric balloon migration: A case report. Int J Surg Case Rep. 2017;41:287-91.
  • 26. Tate CM, Geliebter A. Intragastric balloon treatment for obesity: review of recent studies. Adv Ther. 2017;34:1859-75.
  • 27. Courcoulas A, Abu Dayyeh BK, Eaton L, Robinson J, Woodman G, Fusco M, et al. Intragastric balloon as an adjunct to lifestyle intervention: A randomized controlled trial. Int J Obes (Lond). 2017;41:427-33.
  • 28. Kaya B, Esen Bulut N, Fersahoglu M. Is intragastric botulinum toxin A injection effective in obesity treatment? Surgery Research and Practice. 2020;2020:2419491.
  • 29. Gui D, Mingrone G, Valenza V, Spada P, Mutignani M, Runfola M, et al. Effect of botulinum toxin antral injection on gastric emptying and weight reduction in obese patients: a pilot study. Aliment Pharmacol Ther. 2006;23:675-80.
  • 30. Fuller NR, Pearson S, Lau NS, Wlodarczyk J, Halstead MB, Tee HP, et al. An intragastric balloon in the treatment of obese individuals with metabolic syndrome: a randomized controlled study. Obesity (Silver Spring). 2013;21:1561-70.
  • 31. Sullivan S, Swain J, Woodman G, Edmundowicz S, Hassanein T, Shayani V, et al. Randomized sham-controlled trial of the 6-month swallowable gas-filled intragastric balloon system for weight loss. Surg Obes Relat Dis. 2018;14:1876-89.
  • 32. Keren D, Rainis T. Intragastric balloons for overweight populations—1 year post removal. Obes Surg. 2018;28:2368-73.
  • 33. Wang TJ, Ryou M. Emerging Endoscopic Therapies for Weight Loss. Gastrointestinal Interventional Endoscopy: Springer; 2020.p.199-210.
  • 34. Bang CS, Baik GH, Kim HS, Park SH, Kim EJ, Kim JB, et al. Upper GI Tract: Effect of ıntragastric ınjection of botulinum toxin a for the treatment of obesity: A Systematic Review And Meta-Analysis. Korean Society Of Internal Medicine Fall Conference Proceedings. 2014:(PS 0770) 513-513.
  • 35. Kanlioz M, Ekici U. How taking into account the pyloric tonus contributes to treatment success while administering gastric “botulinum toxin A” for weight loss. Obes Surg. 2020;30:3365-9.

Comparison of The Short-Term Effects of Intragastric Balloon and Botulinum Toxin Injection On Weight Loss

Yıl 2022, Cilt: 7 Sayı: 3, 51 - 55, 26.12.2022
https://doi.org/10.25000/acem.1168617

Öz

Aim: To compare the effects of endoscopic intragastric balloon (IGB) placement and intragastric botulinum toxin-A (BTX-A) injection in terms of weight loss among patients with non-morbid obesity.
Methods: This retrospective single center study was conducted between 01.08.2020 and 01.01.2022. A total of 39 patients with a body mass index (BMI) of <40 without comorbidities were included in the study. Nineteen underwent intragastric BTX-A injection and 20 underwent IGB placement. Patients were evaluated 1 month and 6 months after the procedures.
Results: Mean age was 39.4 ± 8.6 in the BTX-A group and 37.3 ± 10.4 in the IGB group (p = 0.496). 78.9% of the BTX-A group and 75.0% of the IGB group were female (p = 1.000). In both groups, the median weight 1 month after the procedure was significantly lower than before the procedure, and the median weight 6 months after the procedure was significantly lower than 1 month after the procedure (p<0.001 for both groups). The median weight loss in the IGB group at both the 1st and 6th months was significantly greater than the corresponding values of the BTX-A group (p < 0.001 for both).
Conclusion: IGB insertion appears to be a more successful endoscopic bariatric procedure than intragastric BTX-A injection, as measured by weight loss at post-intervention 1 month and 6 months. IGB may be preferred in patients with a BMI below 40 without obesity-related comorbidity.

Kaynakça

  • References 1. Stavrou G, Shrewsbury A, Kotzampassi K. Six intragastric balloons: Which to choose? World J Gastrointest Endosc. 2021;13:238-59.
  • 2. Bustamante F, Brunaldi VO, Bernardo WM, De Moura DTH, De Moura ETH, Galvão M, et al. Obesity treatment with botulinum toxin-A is not effective: a systematic review and meta-analysis. Obes Surg. 2017;27:2716-23.
  • 3. Emile SH, Mahdy T, Schou C, Kramer M, Shikora S. Systematic review of the outcome of single-anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity with proportion meta-analysis of improvement in diabetes mellitus. Int J Surg. 2021;92:106024.
  • 4. Ball W, Raza SS, Loy J, Riera M, Pattar J, Adjepong S, et al. Effectiveness of ıntra-gastric balloon as a bridge to definitive surgery in the super obese. Obes Surg. 2019;29:1932-6.
  • 5. Barrichello S, Badurdeen D, Hedjoudje A, Neto MG, Yance R, Veinert A, et al. The effect of the ıntra-gastric balloon on gastric emptying and the demeester score. Obes Surg. 2020;30:38-45.
  • 6. Behary J, Kumbhari V. Advances in the endoscopic management of obesity. Gastroenterol Res Pract. 2015;2015:757821.
  • 7. Bang CS, Baik GH, Shin IS, Kim JB, Suk KT, Yoon JH, et al. Effect of intragastric injection of botulinum toxin A for the treatment of obesity: a meta-analysis and meta-regression. Gastrointest Endosc. 2015;81:1141-9. e7.
  • 8. De Castro ML, Morales MJ, Martínez-Olmos MA, Pineda JR, Cid L, Estévez P, et al. Safety and effectiveness of gastric balloons associated with hypocaloric diet for the treatment of obesity. Rev Esp Enferm Dig. 2013;105:529-36.
  • 9. Trang J, Lee SS, Miller A, Cruz Pico CX, Postoev A, Ibikunle I, et al. Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients - A systematic review and meta-analysis. Int J Surg. 2018;57:22-9.
  • 10. Barrichello Junior SA, Ribeiro IB, Fittipaldi-Fernandez RJ, Hoff AC, De Moura DTH, Minata MK, et al. Exclusively endoscopic approach to treating gastric perforation caused by an intragastric balloon: case series and literature review. Endosc Int Open. 2018;6:E1322-e9.
  • 11. Zheng Y, Wang M, He S, Ji G. Short-term effects of intragastric balloon in association with conservative therapy on weight loss: a meta-analysis. J Transl Med. 2015;13:246.
  • 12. Genco A, Cipriano M, Bacci V, Cuzzolaro M, Materia A, Raparelli L, et al. BioEnterics Intragastric Balloon (BIB): a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes (Lond). 2006;30:129-33.
  • 13. Ashrafian H, Monnich M, Braby TS, Smellie J, Bonanomi G, Efthimiou E. Intragastric balloon outcomes in super-obesity: a 16-year city center hospital series. Surg Obes Relat Dis. 2018;14:1691-9.
  • 14. Telem DA, Ghaferi AA. Gastric Balloons for Weight Loss in 2020. JAMA. 2020;324:2206-7.
  • 15. Saber AA, Shoar S, Almadani MW, Zundel N, Alkuwari MJ, Bashah MM, et al. Efficacy of first-time ıntragastric balloon in weight loss: A systematic review and meta-analysis of randomized controlled trials. Obes Surg. 2017;27:277-87.
  • 16. Peeters TL. Potential of ghrelin as a therapeutic approach for gastrointestinal motility disorders. Curr Opin Pharmacol. 2006;6:553-8.
  • 17. Foschi D, Corsi F, Lazzaroni M, Sangaletti O, Riva P, La Tartara G, et al. Treatment of morbid obesity by intraparietogastric administration of botulinum toxin: a randomized, double-blind, controlled study. Int J Obes. 2007;31:707-12.
  • 18. Topazian M, Camilleri M, Enders FT, Clain JE, Gleeson FC, Levy MJ, et al. Gastric antral injections of botulinum toxin delay gastric emptying but do not reduce body weight. Clin Gastroenterol Hepatol. 2013;11:145-50. e1.
  • 19. Durmus A, Durmus I, Akbas H, Tinkir NS. A456 The efficacy of ıntragastric balloon versus botulinum toxin ınjection ın obese patients. Surg Obes Relat Dis. 2019;15:S187-S8.
  • 20. Kanlioz M, Ekici U, Tatli F, Karatas T. Efficacy of intragastric balloon placement and botulinum toxin injection in bariatric endoscopy. Surg Laparosc Endosc Percutan Tech. 2020;30:500-3.
  • 21. Vargas EJ, Bazerbachi F, Calderon G, Prokop LJ, Gomez V, Murad MH, et al. Changes in time of gastric emptying after surgical and endoscopic bariatrics and weight loss: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2020;18:57-68. e5.
  • 22. Kakarla VR, Nandipati K, Lalla M, Castro A, Merola S. Are laparoscopic bariatric procedures safe in superobese (BMI ≥50 kg/m2) patients? An NSQIP data analysis. Surg Obes Relat Dis. 2011;7:452-8.
  • 23. Ribeiro IB, Gestic MA, Utrini MP, Chaim FDM, Chaim EA, Cazzo E. Drain amylase levels may indicate gastrojejunostomy leaks after roux-en-y gastric bypass. Arq Gastroenterol. 2018;55:66-72.
  • 24. Charalambous MP, Thompson J, Efthimiou E. Late gastric perforation after insertion of intragastric balloon for weight loss--video case report and literature review. Surg Obes Relat Dis. 2012;8:121-3.
  • 25. Al-Subaie S, Al-Barjas H, Al-Sabah S, Al-Helal S, Alfakharani A, Termos S. Laparoscopic management of a small bowel obstruction secondary to Elipse intragastric balloon migration: A case report. Int J Surg Case Rep. 2017;41:287-91.
  • 26. Tate CM, Geliebter A. Intragastric balloon treatment for obesity: review of recent studies. Adv Ther. 2017;34:1859-75.
  • 27. Courcoulas A, Abu Dayyeh BK, Eaton L, Robinson J, Woodman G, Fusco M, et al. Intragastric balloon as an adjunct to lifestyle intervention: A randomized controlled trial. Int J Obes (Lond). 2017;41:427-33.
  • 28. Kaya B, Esen Bulut N, Fersahoglu M. Is intragastric botulinum toxin A injection effective in obesity treatment? Surgery Research and Practice. 2020;2020:2419491.
  • 29. Gui D, Mingrone G, Valenza V, Spada P, Mutignani M, Runfola M, et al. Effect of botulinum toxin antral injection on gastric emptying and weight reduction in obese patients: a pilot study. Aliment Pharmacol Ther. 2006;23:675-80.
  • 30. Fuller NR, Pearson S, Lau NS, Wlodarczyk J, Halstead MB, Tee HP, et al. An intragastric balloon in the treatment of obese individuals with metabolic syndrome: a randomized controlled study. Obesity (Silver Spring). 2013;21:1561-70.
  • 31. Sullivan S, Swain J, Woodman G, Edmundowicz S, Hassanein T, Shayani V, et al. Randomized sham-controlled trial of the 6-month swallowable gas-filled intragastric balloon system for weight loss. Surg Obes Relat Dis. 2018;14:1876-89.
  • 32. Keren D, Rainis T. Intragastric balloons for overweight populations—1 year post removal. Obes Surg. 2018;28:2368-73.
  • 33. Wang TJ, Ryou M. Emerging Endoscopic Therapies for Weight Loss. Gastrointestinal Interventional Endoscopy: Springer; 2020.p.199-210.
  • 34. Bang CS, Baik GH, Kim HS, Park SH, Kim EJ, Kim JB, et al. Upper GI Tract: Effect of ıntragastric ınjection of botulinum toxin a for the treatment of obesity: A Systematic Review And Meta-Analysis. Korean Society Of Internal Medicine Fall Conference Proceedings. 2014:(PS 0770) 513-513.
  • 35. Kanlioz M, Ekici U. How taking into account the pyloric tonus contributes to treatment success while administering gastric “botulinum toxin A” for weight loss. Obes Surg. 2020;30:3365-9.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Orjinal Makale
Yazarlar

Muzaffer Al 0000-0002-0187-3247

Yayımlanma Tarihi 26 Aralık 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 7 Sayı: 3

Kaynak Göster

Vancouver Al M. Comparison of The Short-Term Effects of Intragastric Balloon and Botulinum Toxin Injection On Weight Loss. Arch Clin Exp Med. 2022;7(3):51-5.