Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients

被引:121
作者
Fogel, Roberto [1 ]
De Fogel, Juana [1 ]
Bonilla, Ydaly [1 ]
De La Fuente, Rafael [2 ]
机构
[1] Hosp Clin Caracas, Dept Gastroenterol, Caracas, Venezuela
[2] Hosp Clin Caracas, Dept Surg, Caracas, Venezuela
关键词
D O I
10.1016/j.gie.2007.10.061
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Bariatric surgery for severe obesity has demonstrated significant health benefits, but it is rot without complications. Transoral approaches to weight loss offer a minimally invasive option. Objective: To evaluate the safety and feasibility of a transoral suturing procedure for weight loss. Design: Single-center, uncontrolled study with a 1-year follow-up. Setting: Hospital de Clinicas, Caracas, Venezuela. Patients: Sixty-four patients (mean age [SD] 31.5 +/- 10.1 years, range 16-62 years; mean (SD) preoperative body mass index [BMI] 39.9 +/- 5.1 kg/m(2), range 28.0-60.2 kg/m(2)) were enrolled between 2003 and 2005. Intervention: Endoluminal vertical gastroplasty by using a continuous suture pattern to treat obesity. Main Outcome Measurements: Short-term complication monitoring and patient weight before the procedure and at 1, 3, and 12 months after the procedure. Results: The outpatient procedures were performed in approximately 45 minutes. Patients had a significant reduction in BMI at 12 months (mean [SD] BMI 39.9 +/- 5.1 kg/m(2) vs 30.6 +/- 4.7 kg/m(2); P < .001) and a percentage of excess weight loss (%EWL) (SD) of 21.1 +/- 6.2, 39.6 +/- 11.3, and 58.1 +/- 19.9 at 1, 3, and 12 months, respectively By comparing the study's subpopulations, group I (baseline BMI >= 40 kg/m(2), n = 33), group II (baseline BMI 35-40 kg/m(2), n = 19), and group III (baseline BMI < 35 kg/m(2), n = 12) demonstrated a %EWL (SD) of 48.9 +/- 10.7, 56.5 +/- 13.9, and 85.1 +/- 24.0, respectively, at 12 months after the procedure (P = .037 when comparing group I vs II; P < .001 when comparing group II vs III and group I vs III). No patients experienced any serious adverse events. Limitations: This study represents a single center's clinical experience, with no sham control. Conclusions: Endoluminal vertical gastroplasty by using a continuous suture pattern is associated with significant weight loss. Additional studies are needed to demonstrate the procedure's long-term safety and efficacy.
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页码:51 / 58
页数:8
相关论文
共 19 条
[1]
[Anonymous], 1983, Statistical Bulletin, Metropolitan Life Insurance Company, V64, P2
[2]
[Anonymous], 1998, CLIN GUID ID EV TREA
[3]
Bariatric surgery and long-term control of morbid obesity [J].
Brolin, RE .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (22) :2793-2796
[4]
Bariatric surgery: A systematic review and meta-analysis [J].
Buchwald, H ;
Avidor, Y ;
Braunwald, E ;
Jensen, MD ;
Pories, W ;
Fahrbach, K ;
Schoelles, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (14) :1724-1737
[5]
BUCHWALD H, 1997, REOPERATIVE GENERAL
[6]
What are the benefits of moderate weight loss? [J].
de Leiva, A .
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 1998, 106 :10-13
[7]
Metabolic bone disease after gastric bypass surgery for obesity [J].
De Prisco, C ;
Levine, SN .
AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 2005, 329 (02) :57-61
[8]
Prevalence and trends in obesity among US adults, 1999-2000 [J].
Flegal, KM ;
Carroll, MD ;
Ogden, CL ;
Johnson, CL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (14) :1723-1727
[9]
Follow-up of nutritional and metabolic problems after bariatric surgery [J].
Fujioka, K .
DIABETES CARE, 2005, 28 (02) :481-484
[10]
GOLDSTEIN DJ, 1992, INT J OBESITY, V16, P397