New Era: Endoscopic treatment options in obesity–a paradigm shift  

作　　者：Jason Glass Ahson Chaudhry Muhammad S Zeeshan Zeeshan Ramzan 

机构地区：[1]Department of Digestive and Liver Diseases,University of Texas Southwestern Medical Center,Dallas,TX 75390,United States [2]Division of Gastroenterology and Hepatology,Department of Medicine,Dallas VA Medical Center,VA North Texas Health Care System,Dallas,TX 75216,United States [3]School of Medicine,Temple University Hospital,Philadelphia,PA 19140,United States

出　　处：《World Journal of Gastroenterology》2019年第32期4567-4579,共13页世界胃肠病学杂志（英文版）

摘　　要：The prevalence of obesity continues to rise,and along with it comes a multitude of health-related consequences.The healthcare community has consistently struggled with providing treatment options to obese patients,in part due to the reluctance of patients in pursuing the more effective(yet invasive)surgical approaches such as sleeve gastrectomy and Rou-en-Y gastric bypass.On the other hand,the less invasive approach such as lifestyle/behavioral interventions and pharmacotherapy(Orlistat,Phenteramine,Phentermine/Topiramate,Locaserin,Naltrexon/Buproprion,and Liraglutide)have very limited efficacy,especially in the morbidly obese patients.Despite our best efforts,the epidemic of obesity continues to rise and pose enormous costs on our healthcare system and society.Bariatric endoscopy is an evolving field generated to combat this epidemic through minimally invasive techniques.These procedures can be performed in an ambulatory setting,are potentially reversible,repeatable,and pose less complications than their invasive surgical counterparts.These modalities are designed to alter gut metabolism by means of space occupation,malabsorption,or restriction.In this review we will discuss different bariatric endoscopic options(such as intragastric balloons,endoscopic sleeve gastroplasty,endoscopic aspiration therapies and gastrointestinal bypass sleeves),their advantages and disadvantages,and suggest a new paradigm where providers may start incorporating this modality in their treatment approach for obese patients.The prevalence of obesity continues to rise, and along with it comes a multitude of health-related consequences. The healthcare community has consistently struggled with providing treatment options to obese patients, in part due to the reluctance of patients in pursuing the more effective(yet invasive) surgical approaches such as sleeve gastrectomy and Rou-en-Y gastric bypass. On the other hand, the less invasive approach such as lifestyle/behavioral interventions and pharmacotherapy(Orlistat, Phenteramine, Phentermine/Topiramate,Locaserin, Naltrexon/Buproprion, and Liraglutide) have very limited efficacy,especially in the morbidly obese patients. Despite our best efforts, the epidemic of obesity continues to rise and pose enormous costs on our healthcare system and society. Bariatric endoscopy is an evolving field generated to combat this epidemic through minimally invasive techniques. These procedures can be performed in an ambulatory setting, are potentially reversible, repeatable, and pose less complications than their invasive surgical counterparts. These modalities are designed to alter gut metabolism by means of space occupation,malabsorption, or restriction. In this review we will discuss different bariatric endoscopic options(such as intragastric balloons, endoscopic sleeve gastroplasty,endoscopic aspiration therapies and gastrointestinal bypass sleeves), their advantages and disadvantages, and suggest a new paradigm where providers may start incorporating this modality in their treatment approach for obese patients.

关 键 词：BARIATRIC endoscopy BARIATRICS OBESITY Intragastric BALLOON BARIATRIC medicine AspireAssist ENDOSCOPIC sleeve GASTROPLASTY 

分 类 号：R[医药卫生]