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Published in: Obesity Surgery 12/2020

01-12-2020 | Obesity | Original Contributions

Intragastric Balloon: a Retrospective Evaluation of 5874 Patients on Tolerance, Complications, and Efficacy in Different Degrees of Overweight

Authors: Ricardo José Fittipaldi-Fernandez, Idiberto José Zotarelli-Filho, Cristina Fajardo Diestel, Márcia Regina Simas Torres Klein, Marcelo Falcão de Santana, João Henrique Felicio de Lima, Fernando Santos Silva Bastos, Newton Teixeira dos Santos

Published in: Obesity Surgery | Issue 12/2020

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Abstract

Background

Endoscopic methods, especially the intragastric balloon (IGB), have been shown to be effective for the treatment of excess weight. This study aimed to assess the tolerance, complications, and efficacy of excess weight treatment with a non-adjustable IGB during 6 months.

Methods

A total of 5874 patients treated with a liquid-filled IGB (600–700 mL) and followed up by a multidisciplinary team were evaluated. Participants presented an initial body mass index (BMI) ≥ 25 kg/m2 and were stratified according to sex and degree of overweight (overweight and obesity grades I, II, and III).

Results

The incidence of complications was 7.32% (n = 430): 6.10% (n = 357) early IGB removal, 0.20% (n = 12) gas production inside the balloon, 0.54% (n = 32) leakage, 0.32% (n = 19) pregnancy, 0.07% (n = 4) gastric perforation, 0.05% (n = 3) upper digestive bleeding, 0.01% (n = 1) Wernicke-Korsakoff syndrome due to excessive vomiting, and 0.02% each (n = 1) pancreatitis and esophagus perforation. The 5444 remaining patients (4081 women, 38 ± 38 years) presented a weight loss of 19.13 ± 8.86 kg and a BMI decreased significantly (p < 0.0001) (36.94 ± 5.67 vs. 30.08 ± 5.06 kg/m2). The % total weight loss (%TWL) was 18.42 ± 7.25%, and the % excess weight loss (%EWL) was 65.66 ± 36.24%. The treatment success rate (%TWL ≥ 10%) was 85%. The %EWL was higher in the pre-obese group (122.19%), followed by obesity grades I (76.67%), II (56.01%), and III (45.45%), with p < 0.0001 for each group. %EWL was higher in women (69.71%) than in men (53.39), with p < 0.0001 for each group. There was also a statistical difference between the TWL and EWL groups, with p < 0.001 for all analyses.

Conclusion

Endoscopic IGB treatment for excess weight is an excellent therapeutic option for patients with different degrees of overweight.
Literature
2.
go back to reference Jensen MD, Ryan DH, Apovian CM, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023.CrossRef Jensen MD, Ryan DH, Apovian CM, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023.CrossRef
3.
go back to reference Yumuk V, Tsigos C, Fried M, et al. Obesity management task force of the European association for the study of obesity. European guidelines for obesity Management in Adults. Obes Facts. 2015;8(6):402–24.CrossRef Yumuk V, Tsigos C, Fried M, et al. Obesity management task force of the European association for the study of obesity. European guidelines for obesity Management in Adults. Obes Facts. 2015;8(6):402–24.CrossRef
4.
go back to reference Ryan DH, Kahan S. Guideline recommendations for obesity management. Med Clin North Am. 2018;102(1):49–63.CrossRef Ryan DH, Kahan S. Guideline recommendations for obesity management. Med Clin North Am. 2018;102(1):49–63.CrossRef
5.
go back to reference Ali MR, Moustarah F, Kim JJ. American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery position statement on intragastric balloon therapy endorsed by the Society of American Gastrointestinal and Endoscopic Surgeons. Surg Obes Relat Dis. 2016;12(3):462–7.CrossRef Ali MR, Moustarah F, Kim JJ. American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery position statement on intragastric balloon therapy endorsed by the Society of American Gastrointestinal and Endoscopic Surgeons. Surg Obes Relat Dis. 2016;12(3):462–7.CrossRef
6.
go back to reference Neto MG, Silva LB, Grecco E, de Quadros LG, Teixeira A, Souza T et al. Brazilian intragastric balloon consensus statement (BIBC): practical guidelines based on experience of over 40,000 cases. Surg Obes Relat Dis. 2017;28. Neto MG, Silva LB, Grecco E, de Quadros LG, Teixeira A, Souza T et al. Brazilian intragastric balloon consensus statement (BIBC): practical guidelines based on experience of over 40,000 cases. Surg Obes Relat Dis. 2017;28.
7.
go back to reference Leeman MF, Ward C, Duxbury M, et al. The intra-gastric balloon for pre-operative weight loss in bariatric surgery: is it worthwhile? Obes Surg. 2013;23(8):1262–5.CrossRef Leeman MF, Ward C, Duxbury M, et al. The intra-gastric balloon for pre-operative weight loss in bariatric surgery: is it worthwhile? Obes Surg. 2013;23(8):1262–5.CrossRef
8.
go back to reference Kim SH, Chun HJ, Choi HS, et al. Current status of intragastric balloon for obesity treatment. World J Gastroenterol. 2016;22(24):5495–504.CrossRef Kim SH, Chun HJ, Choi HS, et al. Current status of intragastric balloon for obesity treatment. World J Gastroenterol. 2016;22(24):5495–504.CrossRef
9.
go back to reference WHO - World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO Techinical Report Series (894).Geneva, 2000. WHO - World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO Techinical Report Series (894).Geneva, 2000.
10.
go back to reference Lopez-Nava G, Rubio MA, Prados S, et al. BioEnterics® Intragastric Balloon (BIB®). Single ambulatory center Spanish experience with 714 consecutive patients treated with one or two consecutive balloons. Obes Surg. 2011;21:5–9.CrossRef Lopez-Nava G, Rubio MA, Prados S, et al. BioEnterics® Intragastric Balloon (BIB®). Single ambulatory center Spanish experience with 714 consecutive patients treated with one or two consecutive balloons. Obes Surg. 2011;21:5–9.CrossRef
11.
go back to reference Yahia M, Najeh H, Zied H, et al. Wernicke's encephalopathy: a rare complication of hyperemesis gravidarum. Anaesth Crit Care Pain Med. 2015;34(3):173–7.CrossRef Yahia M, Najeh H, Zied H, et al. Wernicke's encephalopathy: a rare complication of hyperemesis gravidarum. Anaesth Crit Care Pain Med. 2015;34(3):173–7.CrossRef
12.
go back to reference Nunes CG, Pajecki D, de Melo ME, et al. Assessment of weight loss with the intragastric balloon in patients with different degrees of obesity. Surg Laparosc Endosc Percutan Tech. 2017;27(4):e83–6.CrossRef Nunes CG, Pajecki D, de Melo ME, et al. Assessment of weight loss with the intragastric balloon in patients with different degrees of obesity. Surg Laparosc Endosc Percutan Tech. 2017;27(4):e83–6.CrossRef
13.
go back to reference Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of intragastric balloon. Obes Surg. 2004;14:991–8.CrossRef Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of intragastric balloon. Obes Surg. 2004;14:991–8.CrossRef
14.
go back to reference Genco A, Bruni T, Doldi SB, et al. BioEnterics Intragastric balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15:1161–4.CrossRef Genco A, Bruni T, Doldi SB, et al. BioEnterics Intragastric balloon: the Italian experience with 2,515 patients. Obes Surg. 2005;15:1161–4.CrossRef
15.
go back to reference Forlano R, Ippolito AM, Iacobellis A, et al. Effect of the BioEnterics intragastric balloon on weight, insulin resistance, and liver steatosis in obese patients. Gastrointest Endosc. 2010;71:927–33.CrossRef Forlano R, Ippolito AM, Iacobellis A, et al. Effect of the BioEnterics intragastric balloon on weight, insulin resistance, and liver steatosis in obese patients. Gastrointest Endosc. 2010;71:927–33.CrossRef
16.
go back to reference Genco A, López-Nava G, Wahlen C, et al. Multi-centre European experience with Intragastric balloon in overweight populations: 13 years of experience. Obes Surg. 2013;23:515–21.CrossRef Genco A, López-Nava G, Wahlen C, et al. Multi-centre European experience with Intragastric balloon in overweight populations: 13 years of experience. Obes Surg. 2013;23:515–21.CrossRef
17.
go back to reference Mitura K, Garnysz K. Tolerance of intragastric balloon and patient’s satisfaction in obesity treatment. Wideochir Inne Tech Maloinwazyjne. 2015 Sep;10(3):445–9.PubMedPubMedCentral Mitura K, Garnysz K. Tolerance of intragastric balloon and patient’s satisfaction in obesity treatment. Wideochir Inne Tech Maloinwazyjne. 2015 Sep;10(3):445–9.PubMedPubMedCentral
18.
go back to reference Al-Sabah S, Al-Ghareeb F, Ali DA, et al. Efficacy of intragastric balloon for the management of obesity: experience from Kuwait. Surg Endosc. 2016;30(2):424–9.CrossRef Al-Sabah S, Al-Ghareeb F, Ali DA, et al. Efficacy of intragastric balloon for the management of obesity: experience from Kuwait. Surg Endosc. 2016;30(2):424–9.CrossRef
19.
go back to reference Guedes EP, Madeira E, Mafort TT, et al. Impact of 6 months of treatment with intragastric balloon on body fat and quality of life in obese individuals with metabolic syndrome. Health Qual Life Outcomes. 2017;15:211.CrossRef Guedes EP, Madeira E, Mafort TT, et al. Impact of 6 months of treatment with intragastric balloon on body fat and quality of life in obese individuals with metabolic syndrome. Health Qual Life Outcomes. 2017;15:211.CrossRef
20.
go back to reference Reimão SM, da Silva MER, Nunes GC, et al. Improvement of body composition and quality of life following intragastric balloon. Obes Surg. 2018 Jun;28(6):1806–8.CrossRef Reimão SM, da Silva MER, Nunes GC, et al. Improvement of body composition and quality of life following intragastric balloon. Obes Surg. 2018 Jun;28(6):1806–8.CrossRef
21.
go back to reference Imaz I, Martínez-Cervell C, García-Alvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A metaanalysis Obes Surg. 2008;18:841–6.CrossRef Imaz I, Martínez-Cervell C, García-Alvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A metaanalysis Obes Surg. 2008;18:841–6.CrossRef
22.
go back to reference Moura D, Oliveira J, De Moura EG, et al. Effectiveness of intragastric balloon for obesity: a systematic review and meta-analysis based on randomized control trials. Surg Obes Relat Dis. 2016;12(2):420–9.CrossRef Moura D, Oliveira J, De Moura EG, et al. Effectiveness of intragastric balloon for obesity: a systematic review and meta-analysis based on randomized control trials. Surg Obes Relat Dis. 2016;12(2):420–9.CrossRef
23.
go back to reference Roman S, Napoléon B, Mion F, et al. Intragastric balloon for “non-morbid” obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg. 2004;14:539–44.CrossRef Roman S, Napoléon B, Mion F, et al. Intragastric balloon for “non-morbid” obesity: a retrospective evaluation of tolerance and efficacy. Obes Surg. 2004;14:539–44.CrossRef
24.
go back to reference Stimac D, Majanović SK, Turk T, et al. Intragastric balloon treatment for obesity: results of a large single center prospective study. Obes Surg. 2011;21:551–5.CrossRef Stimac D, Majanović SK, Turk T, et al. Intragastric balloon treatment for obesity: results of a large single center prospective study. Obes Surg. 2011;21:551–5.CrossRef
25.
go back to reference Dumonceau JM. Evidence-based review of the bioenterics intragastric balloon for weight loss. Obes Surg. 2008;18:1611–7.CrossRef Dumonceau JM. Evidence-based review of the bioenterics intragastric balloon for weight loss. Obes Surg. 2008;18:1611–7.CrossRef
26.
go back to reference Fernandes FAM, Carvalho GL, Lima DL, et al. Intragastric balloon for overweight patients. JSLS. 2016;20(1):e2015.00107.CrossRef Fernandes FAM, Carvalho GL, Lima DL, et al. Intragastric balloon for overweight patients. JSLS. 2016;20(1):e2015.00107.CrossRef
Metadata
Title
Intragastric Balloon: a Retrospective Evaluation of 5874 Patients on Tolerance, Complications, and Efficacy in Different Degrees of Overweight
Authors
Ricardo José Fittipaldi-Fernandez
Idiberto José Zotarelli-Filho
Cristina Fajardo Diestel
Márcia Regina Simas Torres Klein
Marcelo Falcão de Santana
João Henrique Felicio de Lima
Fernando Santos Silva Bastos
Newton Teixeira dos Santos
Publication date
01-12-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04985-4

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