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肥胖患者的内镜疗法:系统性审查和元分析
Zachary N Weitzner1, Jennifer Phan2, Meron M Begashaw3
1Department of Surgery, David Geffen School of Medicine, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
Surgical endoscopy
|September 21, 2023
概括
透视肥胖治疗比改变生活方式提供更大的减肥,但比传统的减肥手术少. 这些内镜手术可能是寻求更少侵入性选择的患者的可行替代方案.
科学领域:
- 减肥医学是一种减肥医学.
- 胃肠病学 胃肠病学
- 最少侵入性手术是最少侵入性的手术.
背景情况:
- 肥胖是一个重大的公共卫生挑战,传统的减肥手术的利用率很低.
- 新兴的内镜肥胖治疗方法提供了降低的风险,但需要有效性,耐用性和安全性评估.
- 本研究将内镜减肥手术的有效性与现有治疗方法进行比较.
研究的目的:
- 为了比较内镜减肥手术与其他肥胖治疗方法的疗效.
- 评估与各种内镜疗法相关的减肥结果和不良事件.
- 评估内镜疗法的潜力,作为传统减肥手术的替代方案.
主要方法:
- 关于Embase,Cochrane Central和Pubmed (2014-2021) 的一个全面的文献搜索.
- 包括FDA或CE批准的内镜减肥疗法和非内镜治疗.
- 分析了37项涉及15639名患者的研究,重点关注了总体体重减轻率 (%TBWL),多余体重减轻率 (%EBWL) 和不良事件.
主要成果:
- 胃内气球在6个月后产生了7.6-14.1%%TBWL,而改变生活方式时为3.3-6.7%.
- 在6个月内,内镜袖胃口整形 (ESG) 导致较少的%TBWL (4.7-14.4%) 与腹腔镜袖胃口切除 (LSG) (18.8-26.5%) 相比.
- AspireAssist在12个月后显示出比生活方式修改 (3.5-5.9%) 更多的%TBWL (12.1-18.3%);所有内镜干预都比生活方式修改有更高的不良事件率.
结论:
- 与单独改变生活方式相比,内镜减肥疗法可以产生更好的减肥效果.
- 虽然有效,但内镜治疗比传统的减肥手术减轻体重.
- 内镜减肥手术是传统手术对肥胖管理的一种潜在有益的替代方案.
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