title: Intragastric balloon treatment of obesity must be combined with bariatric surgery: a pilot study in Turkey.
abstract: OBJECTIVE
  The treatment of morbid obesity by intragastric balloon (BioEnterics) placement is a safe and effective procedure. Cultural, social and economical factors are known to have an impact on the outcome of therapeutic interventions. This study aimed to evaluate the effect of this method on weight loss and long-term outcome following balloon removal in a cohort of Turkish patients.
  
  
  METHODS
  Twenty-five patients (11 male, 14 female) who selected BioEnterics intragastric balloon method for weight loss over surgery were included in the study. Their mean age was 35.2±13.4 and mean body mass index was 43.5±8.7 kg/m2. Patients who had any contraindication for endoscopic BioEnterics intragastric balloon placement were excluded. BioEnterics intragastric balloon was performed under deep sedation with propofol, and all patients were placed on a 1000 kcal/day diet for six months. Patients were reevaluated six months following balloon removal. Excess weight loss of greater than 25% was considered as end of treatment success. Maintenance of excess weight loss greater than 25% at the end of a six-month follow-up period was considered as long-term success. Results were reported as mean body mass index and mean %excess weight loss±SD. Statistical analysis was done using SPSS computer program.
  
  
  RESULTS
  One patient was excluded from the study because of psychological intolerance (1/25) prompting early balloon removal. Twenty-four patients completed both the initial phase and the follow-up period. At the end of the initial six months, the mean body mass index was 35.7±4.6 kg/m2 and mean excess weight loss was 46.9±11.3%. Although 22 out of 24 patients (91.6%) had achieved end of treatment success, the mean body mass index was back to 41.9±7.7 kg/m2 at the end of the follow-up period. Only two patients were able to maintain excess weight loss of 25% at the completion of the study, resulting in a long-term success rate of 8.3%.
  
  
  CONCLUSIONS
  BioEnterics intragastric balloon is a safe and effective but temporary therapeutic modality for obesity treatment. After BioEnterics intragastric balloon removal, almost all patients had returned to their initial weights. Therefore, BioEnterics intragastric balloon must only be offered for patients who accept to undergo bariatric surgery after BioEnterics intragastric balloon removal. Losing weight by BioEnterics intragastric balloon before bariatric surgery will improve the morbidity and mortality rates of this modality.
authors.affiliation: Department of Gastroenterology, Acıbadem University, School of Medicine, İstanbul. msaruc@hotmail.com
authors.forename: Murat
authors.initials: M
authors.lastname: Saruç
authors.forename: Deniz
authors.initials: D
authors.lastname: Böler
authors.forename: Mehmet
authors.initials: M
authors.lastname: Karaarslan
authors.forename: Çağlar
authors.initials: Ç
authors.lastname: Baysal
authors.forename: Kemal
authors.initials: K
authors.lastname: Rasa
authors.forename: Metin
authors.initials: M
authors.lastname: Çakmakçi
authors.forename: Cihan
authors.initials: C
authors.lastname: Uras
authors.forename: Nurdan
authors.initials: N
authors.lastname: Tözün
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000401:mortality; D015992:Body Mass Index; D002404:Catheterization / Q000009:adverse effects / Q000401:mortality; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D010865:Pilot Projects; D011300:Preoperative Care / Q000379:methods* / Q000401:mortality; D013270:Stomach; D014421:Turkey / Q000453:epidemiology; D015431:Weight Loss