Impact of Intragastric Balloon Before Laparoscopic Gastric Bypass on Patients with Super Obesity: a Randomized Multicenter Study

Coffin, Benoït; Maunoury, V.; Pattou, François; Hébuterne, Xavier; Schneider, Stephen H.; Coupaye, Muriel; Ledoux, Séverine; Iglicki, F.; Mion, François; Robert, M.; Disse, Emmanuel; Escourrou, J.; Tuyeras, G.; Roux, Yannick Le; Arvieux, C.; Pouderoux, Philippe; Huten, N.; Alfaiate, Toni; Hajage, David; Msika, Simon

doi:10.1007/s11695-016-2383-x

Cited by 40 publications

(26 citation statements)

References 31 publications

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“…Abstracts from the remaining articles where evaluated, leaving 25 full articles concerning weight loss prior surgery. After reading the full text, we concluded that only 7 out of 25 papers focused on the effects of weight loss prior to BS [13][14][15][16][17][18][19], and only 3 of them were randomized control trials specifically comparing patients who achieved a significant weight loss before surgery with patients who did not [13][14][15]. The characteristics of the three trials are reported in Table 1.…”

Section: Controversies About Pre-operative Weight Lossmentioning

confidence: 99%

Diet approach before and after bariatric surgery

Bettini

Belligoli

Fabris

2020

Rev Endocr Metab Disord

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Bariatric surgery (BS) is today the most effective therapy for inducing long-term weight loss and for reducing comorbidity burden and mortality in patients with severe obesity. On the other hand, BS may be associated to new clinical problems, complications and side effects, in particular in the nutritional domain. Therefore, the nutritional management of the bariatric patients requires specific nutritional skills. In this paper, a brief overview of the nutritional management of the bariatric patients will be provided from pre-operative to post-operative phase. Patients with severe obesity often display micronutrient deficiencies when compared to normal weight controls. Therefore, nutritional status should be checked in every patient and correction of deficiencies attempted before surgery. At present, evidences from randomized and retrospective studies do not support the hypothesis that pre-operative weight loss could improve weight loss after BS surgery, and the insurance-mandated policy of a preoperative weight loss as a pre-requisite for admission to surgery is not supported by medical evidence. On the contrary, some studies suggest that a modest weight loss of 5–10% in the immediate preoperative period could facilitate surgery and reduce the risk of complications. Very low calories diet (VLCD) and very low calories ketogenic diets (VLCKD) are the most frequently used methods for the induction of a pre-operative weight loss today. After surgery, nutritional counselling is recommended in order to facilitate the adaptation of the eating habits to the new gastro-intestinal physiology. Nutritional deficits may arise according to the type of bariatric procedure and they should be prevented, diagnosed and eventually treated. Finally, specific nutritional problems, like dumping syndrome and reactive hypoglycaemia, can occur and should be managed largely by nutritional manipulation. In conclusion, the nutritional management of the bariatric patients requires specific nutritional skills and the intervention of experienced nutritionists and dieticians.

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Section: Controversies About Pre-operative Weight Lossmentioning

confidence: 99%

Diet approach before and after bariatric surgery

Bettini

Belligoli

Fabris

2020

Rev Endocr Metab Disord

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“…Air and fluid filled intra-gastric balloons (IGB) have also been tried to achieve weight loss in the super-obese patients. In a randomised multicentre trial of 115 patients, 55 patients with a BMI of 54 kg/m 2 had IGB inserted for 6 months which led to a BMI loss of 2.8 kg/m 2 but this did not improve the peri-operative outcomes after laparoscopic gastric bypass [ 23 ]. This magnitude of weight loss could be achieved with diet, behaviour and exercise regimes [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study

et al. 2018

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BackgroundObesity surgery mortality risk scoring system (OS-MRS) classifies patients into high, intermediate and low risk, based on age, body mass index, sex and other comorbidities such as hypertension and history of pulmonary embolism. High-risk patients not only have a higher mortality but are more likely to develop post-operative complications necessitating intervention or prolonged hospital stay following bariatric surgery. Endoscopically placed duodenal-jejunal bypass sleeve (Endobarrier) has been designed to achieve weight loss and improve glycaemic control in morbidly obese patients with clinically proven effectiveness.The aim of this study was to assess if pre-operative insertion of endobarrier in high-risk patients can decrease morbidity and length of stay after bariatric surgery.Materials and MethodsBetween 2012 and 2014, a cohort of 11 high-risk patients had an Endobarrier inserted (E&BS group) for 1 year prior to definitive bariatric surgery. These patients were compared against a similar group undergoing primary bariatric surgery (PBS group) during same duration. The two groups were matched for age, gender, body mass index, comorbidities, surgical procedure and OS-MRS using propensity score matching. Outcome measures included operative time, morbidity, length of stay, intensive therapy unit (ITU) stay, readmission rate, percentage excess weight loss (%EWL) and percentage total weight loss (%TWL).ResultsPatient characteristics and OS-MRS were similar in both groups (match tolerance 0.1). There was no significant difference in total length of stay, readmission rate, %EWL and %TWL. Operative time, ITU stay, post-operative complications and severity of complications were significantly less in the E&BS group (p < 0.05) with significant likelihood of planned ITU admissions in the PBS group (p < 0.05).ConclusionEndobarrier could be considered as a pre bariatric surgical intervention in high-risk patients. It may result in improved post-operative outcomes in high-risk bariatric patients.

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“…Intragastric balloons ( Figure 2) have been thought to provide a potential bridge to bypass surgery in super-obese patients (body mass index >50 kg/m 2 ). In a prospective randomized trial of 115 super-obese patients, 82 55 received intragastric balloons and 60 received standard medical care. Although weight loss was substantial with intragastric balloon, there was no effect on perioperative outcomes.…”

Section: Endoscopic Bariatric Proceduresmentioning

confidence: 99%

Recent Advances in Endoscopy

et al. 2017

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In this narrative review, invited by the Editors of Gastroenterology, we summarize recent advances in the field of gastrointestinal endoscopy. We have chosen articles published primarily in the past 2-3 years. Although a thorough literature review was performed for each topic, the nature of the article is subjective and systematic and is based on the authors' experience and expertise regarding articles we believed were most likely to be of high clinical and scientific importance.

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Impact of Intragastric Balloon Before Laparoscopic Gastric Bypass on Patients with Super Obesity: a Randomized Multicenter Study

Abstract: IGB insertion before LGBP induced weight loss but did not improve the perioperative outcomes or affect postoperative weight loss.

Cited by 40 publications

References 31 publications

Diet approach before and after bariatric surgery

Diet approach before and after bariatric surgery

Endobarrier as a Pre Bariatric Surgical Intervention in High-Risk Patients: a Feasibility Study

Recent Advances in Endoscopy

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