Intragastric Balloon as a First Step Before Metabolic Bariatric Surgery in Patients with BMI ≥ 50 kg/m2: are the Results After Balloon Related to Global Outcomes After Surgery?
Obes Surg
; 34(9): 3195-3202, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-39042307
ABSTRACT
INTRODUCTION:
Patients with body mass index (BMI) ≥ 50 kg/m2, classified with obesity class IV/V, require complex treatments. Intragastric balloon (IGB) is a possible treatment before metabolic bariatric surgery (MBS) that may reduce peri-operative complications. This study evaluates IGB outcomes and complications before MBS in patients with Obesity IV/V, and subsequent MBS results, regarding weight loss and comorbidity resolution.METHODS:
Retrospective cohort study of all patients with BMI above 50 kg/m2 submitted to IGB before MBS between 2009 and 2023 in a high-volume center. Variables analyzed included weight loss after IGB and MBS, IGB complications, and comorbidity resolution. Suboptimal clinical responses were defined as %TWL < 5% for IGB, %TWL < 20% for MBS, and %TWL < 25% or BMI ≥ 35 kg/m2 for IGB + MBS.RESULTS:
Seventy-four patients (mean BMI 58.8 ± 8 kg/m2) were included. After IGB, the mean %TWL was 14.2 ± 8.5%, with a 21.6% complication rate, predominantly nausea and vomiting, and one death. Suboptimal clinical response of IGB affected 13.5% of patients, and 5.4% required early removal. Two years after MBS, the mean %TWL was 38.2 ± 11.6%, mainly due to MBS, yet approximately one-third of %TWL was attributed to IGB. No correlation was found between IGB and MBS outcomes. At 2-year follow-up, 45.1% patients had %TWL ≥ 25 and BMI < 35 kg/m2.CONCLUSION:
The IGB is a treatment option before MBS in patients with Obesity Class IV/V, with acceptable weight loss outcomes but not infrequent complications. A multidisciplinary approach is mandatory, and all treatments must be considered in this difficult subset of patients.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Obesity, Morbid
/
Weight Loss
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Body Mass Index
/
Gastric Balloon
/
Bariatric Surgery
Limits:
Adult
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Obes Surg
/
Obes. surg
/
Obesity surgery
Journal subject:
METABOLISMO
Year:
2024
Type:
Article
Affiliation country:
Portugal