title: Multicenter Randomized Study of Obesity Treatment with Minimally Invasive Injection of Hyaluronic Acid Versus and Combined with Intragastric Balloon.
abstract: BACKGROUND
  Research into minimally invasive techniques is worthwhile for greater acceptance in bariatric surgery, a useful first step being to evaluate the combination of these with current procedures. We suggest that intragastric balloon (IGB) can be performed with hyaluronic acid (HA) injections at the level of the gastroesophageal junction.
  
  
  METHODS
  A submucosal restriction is created by circular injection of an absorbable material within a defined area based on endoscopic anatomy. We included 101 patients in a prospective multicenter randomized trial, with average body mass index (BMI) 33.4 (range 27-44), treated from April 2010 to April 2012 by IGB and/or HA injection, sequentially, and followed for two more years. Patients were divided into group 1 (IGB alone), group 2 (IGB followed by HA at IGB removal, at 6 months), and group 3 (HA and IGB at 6 months).
  
  
  RESULTS
  BMI loss at 6 months was inferior in the HA group (32 patients) compared with the IGB groups (68 patients) (2.1 ± 0.4 versus 3.4 ± 0.3, p < 0.05). The efficacy of IGB alone compared with combined treatments (groups 2 and 3) was significantly inferior at 18 months only, but the impact of the treatment sequence (HA before or after IGB) on BMI loss was not statistically significant, although in favor of HA first.
  
  
  CONCLUSIONS
  This study did not demonstrate the efficacy of HA injections as an obesity treatment.
authors: Polyclinique Lyon-Nord, 941 Rue Capitaine Julien, 69140, Rillieux-la-Pape, France, jerome.dargent@polyclinique-rillieux.fr.
authors: Jerome
authors: J
authors: Dargent
authors: François
authors: F
authors: Mion
authors: Vianna
authors: V
authors: Costil
authors: René
authors: R
authors: Ecochard
authors: Frédéric
authors: F
authors: Pontette
authors: Valentin
authors: V
authors: Mion
authors: Stéphane
authors: S
authors: Angella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D015992:Body Mass Index; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D015905:Gastric Balloon / Q000009:adverse effects; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009767:Obesity, Morbid / Q000601:surgery*; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
chemical_list: D006820:Hyaluronic Acid