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Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients
INTRODUCTION: Bariatric surgery is a safe and effective treatment for obesity, although in super-obese patients (BMI ≥50 kg/m(2)) it can become challenging for anatomical and anesthesiologic issues. Several bridging therapies have been proposed to increase preoperative weight loss and decrease perio...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601677/ https://www.ncbi.nlm.nih.gov/pubmed/37579738 http://dx.doi.org/10.1159/000531459 |
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author | Martines, Gennaro Dezi, Agnese Giove, Carlo Lantone, Valerio Rotelli, Maria Tersa Picciariello, Arcangelo Tomasicchio, Giovanni |
author_facet | Martines, Gennaro Dezi, Agnese Giove, Carlo Lantone, Valerio Rotelli, Maria Tersa Picciariello, Arcangelo Tomasicchio, Giovanni |
author_sort | Martines, Gennaro |
collection | PubMed |
description | INTRODUCTION: Bariatric surgery is a safe and effective treatment for obesity, although in super-obese patients (BMI ≥50 kg/m(2)) it can become challenging for anatomical and anesthesiologic issues. Several bridging therapies have been proposed to increase preoperative weight loss and decrease perioperative morbidity and mortality. The aim of this study was to compare the efficacy and safety of different two-stage approaches in super-obese patients: laparoscopic sleeve gastrectomy (LSG) following preoperative liraglutide therapy versus LSG with preoperative intragastric balloon (IGB) during a 1-year follow-up. METHODS: Clinical records of 86 patients affected by super-obesity who underwent two-stage approach between January 2019 and January 2022 were retrospectively reviewed using a prospectively maintained database. Patients were separated into two groups: those managed with preoperative IGB and those with liraglutide 3.0 mg prior to LSG. Weight (kg), BMI (kg/m(2)), %EWL, and %EBWL were reported and compared between the two groups at the end of bridging therapy, at 6th month and 12th month postoperatively. Postoperative complications were recorded. RESULTS: Forty-four patients underwent IGB insertion prior to LSG, while 42 were treated with liraglutide. There were no statistical differences in baseline weight and BMI. At the end of preoperative treatment, the group treated with IGB reported a significant reduction in BMI (47.24 kg/m(2) vs. 53.6 kg/m(2); p < 0.391) compared to liraglutide group. There were no differences recorded between the two groups concerning postoperative complications. At 6 months, the liraglutide group had lower %EWL (15.8 vs. 29.84; p < 0.05) and %EBWL (27.8 vs. 55.6; p < 0.05) when compared to IGB group. At 12 months, the IGB preserved with higher %EWL (39.9 vs. 25; p < 0.05) and %EBWL (71.2 vs. 42; p < 0.05). CONCLUSION: A two-stage therapeutic approach with IGB prior to LSG in super-obese patients could be considered an attractive alternative to liraglutide as bridging therapy before bariatric surgery. |
format | Online Article Text |
id | pubmed-10601677 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-106016772023-10-27 Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients Martines, Gennaro Dezi, Agnese Giove, Carlo Lantone, Valerio Rotelli, Maria Tersa Picciariello, Arcangelo Tomasicchio, Giovanni Obes Facts Research Article INTRODUCTION: Bariatric surgery is a safe and effective treatment for obesity, although in super-obese patients (BMI ≥50 kg/m(2)) it can become challenging for anatomical and anesthesiologic issues. Several bridging therapies have been proposed to increase preoperative weight loss and decrease perioperative morbidity and mortality. The aim of this study was to compare the efficacy and safety of different two-stage approaches in super-obese patients: laparoscopic sleeve gastrectomy (LSG) following preoperative liraglutide therapy versus LSG with preoperative intragastric balloon (IGB) during a 1-year follow-up. METHODS: Clinical records of 86 patients affected by super-obesity who underwent two-stage approach between January 2019 and January 2022 were retrospectively reviewed using a prospectively maintained database. Patients were separated into two groups: those managed with preoperative IGB and those with liraglutide 3.0 mg prior to LSG. Weight (kg), BMI (kg/m(2)), %EWL, and %EBWL were reported and compared between the two groups at the end of bridging therapy, at 6th month and 12th month postoperatively. Postoperative complications were recorded. RESULTS: Forty-four patients underwent IGB insertion prior to LSG, while 42 were treated with liraglutide. There were no statistical differences in baseline weight and BMI. At the end of preoperative treatment, the group treated with IGB reported a significant reduction in BMI (47.24 kg/m(2) vs. 53.6 kg/m(2); p < 0.391) compared to liraglutide group. There were no differences recorded between the two groups concerning postoperative complications. At 6 months, the liraglutide group had lower %EWL (15.8 vs. 29.84; p < 0.05) and %EBWL (27.8 vs. 55.6; p < 0.05) when compared to IGB group. At 12 months, the IGB preserved with higher %EWL (39.9 vs. 25; p < 0.05) and %EBWL (71.2 vs. 42; p < 0.05). CONCLUSION: A two-stage therapeutic approach with IGB prior to LSG in super-obese patients could be considered an attractive alternative to liraglutide as bridging therapy before bariatric surgery. S. Karger AG 2023-08-14 /pmc/articles/PMC10601677/ /pubmed/37579738 http://dx.doi.org/10.1159/000531459 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Research Article Martines, Gennaro Dezi, Agnese Giove, Carlo Lantone, Valerio Rotelli, Maria Tersa Picciariello, Arcangelo Tomasicchio, Giovanni Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients |
title | Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients |
title_full | Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients |
title_fullStr | Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients |
title_full_unstemmed | Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients |
title_short | Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients |
title_sort | efficacy of intragastric balloon versus liraglutide as bridge to surgery in super-obese patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601677/ https://www.ncbi.nlm.nih.gov/pubmed/37579738 http://dx.doi.org/10.1159/000531459 |
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