肥胖与内镜下减重治疗研究进展

Advances in obesity and endoscopic bariatric treatment

肥胖症已成为我国重大公共卫生问题,中重度肥胖患者进行饮食运动干预效果有限且难以长期坚持,而减重手术由于手术风险和较高成本临床应用受到一定限制。内镜下减重治疗具有更微创、恢复快、可逆、可重复、并发症少等优势,在设备、技术、理念等方面不断发展,有望成为减重代谢手术的并行和补充治疗。内镜下减重治疗依据原理可分为限制胃容量、减少肠道吸收、内镜下修正手术三大类。内镜减重可联合药物、减重手术进行综合治疗,将成为肥胖症多学科综合治疗中重要的一个环节。

Obesity has become a major public health problem in China.Diet and exercise interventions in patients with moderate to severe obesity have limited effect and is difficult to adhere to for a long time.The clinical application of bariatric surgery is limited due to the surgical risk and high cost.Endoscopic bariatric therapy(EBT)has the advantages of being more minimally invasive,faster recovery,reversible,repeatable,and less complications.It is constantly developing in terms of equipment,technology,and concept,and is expected to become a parallel and complementary treatment for bariatric and metabolic surgery.According to the principle,EBT can be divided into three categories:restriction of stomach volume,reduction of intestinal absorption,and endoscopic revisional surgery.EBT can be combined with drugs and bariatric surgery for comprehensive treatment,which will become an important link in the multidisciplinary comprehensive treatment of obesity.