| Abstract | Cilj istraživanja: Utvrditi učinkovitost i podnošljivost intragastričnog balona kod
pretilih ispitanika s ili bez komorbiditeta povezanih s pretilošću. Osim apsolutnog gubitka
tjelesne težine usporediti da li je relativni gubitak veći u morbidno i ekstremno pretilih
(BMI>40) ili kod manje pretilih bolesnika
Metode: U ispitivanje je od siječnja 2011. do sredine 2013. godine uključeno 44
pretilih bolesnika oba spola u dobi od 17 do 62 godina s ITM >35. Nakon uzimanja
anamneze, kliničkog pregleda i antropometrijskih mjerenja, ispitanicima je endoskopski u
lumen želuca postavljen silikonski balon ispunjen s 500 ml fiziološke otopine. Uz
dvomjesečne kontrolne preglede kroz slijedećih 6 mjeseci i precizne pisane upute o
pridržavanju dijetetskog režima, balon je nakon 6 mjeseci izvađen, te su ponovljena sva
antropometrijska i laboratorijska mjerenja s početka ispitivanja radi ocjene učinkovitosti i
neškodljivosti metode.
Rezultati: Ugradnjom balona je prosječna tjelesna težina smanjena za 21,9 kg
(17,3%), BMI za 7,2 (16,8%), eksces tjelesne težine za 39,1%, a eksces BMI za 42,5%.
Značajno su smanjeni i opseg struka i bokova (12,3 i 9,6%). Razlike među ispitanicima
prema dobi i spolu nije evidentirana. Usporedbom morbidno (BMI≥40; 32 ispitanika) i
nemorbidno pretilih (BMI<40; 12 ispitanika) nije nađena razlika za %LBW (z 0,606; p
0,544) i %LEBW - (z 1,75; p 0,079), ali je zabilježena statistički vrlo značajna razlika za
%LBMI - (z 2,4; p 0,016), odnosno grupa s manjim BMI-jem je gubila veći postotak ekscesa BMI u odnosu na morbidno pretile ispitanike ((MI≥40). Najčešće nuspojave bile
su mučnina, povraćanje, grčevi i opstipacija, ali nisu bile razlog niti jednog vađenja balona.
Zaključak: Istraživanje je pokazalo da je ugradnja intragastričnog balona vrlo
učinkovita metoda u liječenju nemorbidne i morbidne pretilosti. Uz gubitak prekomjerne
težine dolazi i do značajnog poboljšanja komorbiditeta povezanih s pretilošću, prije svih
hiperlipidemije i hipertenzije. Metoda je sigurna i dobro podnošljiva, a zabilježene
neželjene pojave su najčešće prolazne, slabog intenziteta i vrlo rijetko zahtijevaju
prijevremeno vađenje balona ili kiruršku intervenciju. |
| Abstract (english) | Study aim: Determining the efficiency and tolerability of an intragastric balloon in
obese subjects with or without comorbidities connected with obesity and comparing
whether the relative loss is higher in morbidly and extremely obese patients (BMI>40) or
in less obese ones.
Methods: The study which lasted between January 2010 and mid-2013 included 44
obese patients of both sexes, between 17 and 62 years of age, and with a BMI>35. After
gathering case histories, conducting clinical exams and anthropometric measurements, a
silicon balloon filled with 500 ml of physiological solution was endoscopically placed into
the lumen of the patients’ stomachs. Following control exams on a bimonthly basis and
precise written instructions on dietary regimen, the balloon was extracted after six months.
At that point, all anthropometric and laboratory measurements from the beginning of the
study were performed again in order to evaluate the efficiency and the harmlessness of the
method.
Results: Following the balloon placement, the average body weight was reduced by
21.9 kg (17.3%), BMI by 7.2 (16.8%), excess body weight by 39.1%, and excess BMI by
42.5%. The circumference of hips and thighs was significantly reduced as well (12.3 and
9.6%). No difference was established in subjects according to age and sex. When
comparing the morbidly (BMI≥40; 32 subjects) and non-morbidly obese (BMI<40; 12
subjects), no difference was identified in the %LBW (z 0.606; p 0.544) and %LEBW (z 1.75; p 0.079). However, a statistically significant difference was identified in %LBMI - (z
2.4; p 0.016), which means that the subject group with a lower BMI has lost a higher
percentage of excess BMI in relation to the morbidly obese subjects (MI≥40). The most
common side effects were nausea, vomiting, cramping and constipation, but these did not
cause any of the balloons to be extracted.
Conclusion: The study showed that the intragastric balloon placement is a highly
efficient method in treating non-morbid and morbid obesity. Along with the excess weight
reduction, there is a significant improvement in the comorbidities connected with obesity,
mostly relating to hyperlipidaemia and hypertension. The method is safe and tolerable, and
the identified unwanted side effects are most often temporary, of low intensity and very
rarely demand an early removal of the balloon or a surgical intervention. |
