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A review of the current status of endoluminal therapy as a primary approach to obesity management

机译：回顾腔内治疗的现状，将其作为肥胖管理的主要方法

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摘要

Gastroenterologists are expected to play a pivotal role in the management of the global obesity epidemic in coming years as novel endoscopic approaches become more widely available, safe, and effective. This review focuses on the recent advances in the field of endoluminal therapy as a primary approach to obesity management with the aim of providing the interventional endoscopist an overview of currently available evidence along with an insight into upcoming devices and techniques. The intragastric balloon appears to be safe and effective in the short term, especially as a bridge to bariatric surgery. Although early trials support the safety and feasibility of endoscopic gastroplasty, it is technically demanding and staple-line dehiscence continues to be a problem. Moreover, with ongoing technical innovations, most devices that have been used in published trials are no longer manufactured and results of studies using newer endoscopic suturing systems are currently awaited. The duodenojejunal bypass sleeve mimics the physiology of intestinal bypass and shares the metabolic advantages of intestinal diversion. A high rate of premature device withdrawal has been its major limiting factor. Therapeutic endoscopy may be the next paradigm of bariatric care. Combining restrictive and barrier endoscopic techniques can potentially improve efficacy and should be evaluated in the setting of appropriate clinical trials.
机译：随着新型内窥镜检查方法变得更加广泛，安全和有效，预计胃肠病学家将在未来几年中在全球肥胖流行的管理中发挥关键作用。这篇综述着重介绍腔内治疗作为肥胖管理的主要方法在腔内治疗领域的最新进展，旨在为介入内镜医师提供当前可用证据的概述以及对即将到来的设备和技术的洞察力。短期内胃内球囊似乎是安全有效的，特别是作为减肥手术的桥梁。尽管早期试验支持内窥镜胃成形术的安全性和可行性，但对技术要求很高，并且吻合线开裂仍然是一个问题。此外，随着技术的不断创新，已公开发表的试验中使用的大多数设备已不再生产，目前正在等待使用新型内窥镜缝合系统的研究结果。十二指肠空肠旁路套模拟肠旁路的生理学，并具有肠转移的代谢优势。设备过早退回的高速率已成为其主要限制因素。内镜治疗可能是减肥治疗的下一个范例。结合限制性内镜和屏障内镜技术可以潜在地提高疗效，应在适当的临床试验中进行评估。

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