期刊
OBESITY SURGERY
卷 22, 期 5, 页码 777-782出版社
SPRINGER
DOI: 10.1007/s11695-011-0571-2
关键词
Bariatric surgery; Super-super obesity; Intragastric balloon; Laparoscopic gastric bypass
类别
Extreme obesity increases morbi-mortality in bariatric surgery. We previously showed that significant weight loss can be obtained within 3 months in super-super obese patients (BMI > 60 kg/m(2)) with an intragastric balloon (IGB). Here, we explored the potential benefit of preoperative IGB on the outcome of laparoscopic gastric bypass (LGBP) in super-super obese patients. In this case-control study, we compared the records of 60 consecutive super-super obese patients (66.5 +/- 3.4 kg/m(2)) submitted to a LGBP between 2004 and 2009, with preoperative IGB (n = 23, cases) or without (n = 37, controls). We analyzed the clinical outcome of surgery and a composite end point of significant adverse events defined as the presence of at least one of the following conditions: conversion to laparotomy, intensive care unit stay for more than 2 days, and overall hospital stay superior to 2 weeks. All baseline clinical and biological characteristics were homogenous between both groups. IGB was maintained during 155 +/- 62 days and induced a loss of 5.5 +/- 1.3 kg/m(2) (11.2 +/- 3.2% of excess body mass index) at the time of LGBP, associated with a decrease in systolic blood pressure and gamma-glutamyl transpeptidase level (p < 0.05 vs. baseline). Operative time was lower in the IGB group (146 +/- 47 vs. 201 +/- 81 min in controls; p < 0.01). Significant adverse events occurred less frequently after LGBP in the IGB group (2 vs. 13 in controls; p < 0.05). All patients were alive at 1 year and overall weight loss was similar in both groups (52.4 +/- 17.3 vs. 50.3 +/- 12.7 percent of excess BMI loss in controls; NS). IGB prior to LGBP in super-super obese patients significantly reduced excess BMI. It was associated with a shorter operative time and a lower overall risk of significant adverse outcomes.
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