Impact of Intragastric Balloon Before Laparoscopic Gastric Bypass on Patients with Super Obesity: a Randomized Multicenter Study.
Super obese patients are recommended to lose weight before bariatric surgery. The effect of intragastric balloon (IGB)-induced weight loss before laparoscopic gastric bypass (LGBP) has not been reported. The aim of this prospective randomized multicenter study was to compare the impact of preoperative 6-month IGB with standard medical care (SMC) in LGBP patients.



Patients with BMI >45 kg/m2selected for LGBP were included and randomized to receive either SMC or IGB. After 6 months (M6), the IGB was removed and LGBP was performed in both groups. Postoperative follow-up period was 6 months (M12). The primary endpoint was the proportion of patients requiring ICU stay >24 h; secondary criteria were weight changes, operative time, hospitalization stay, and perioperative complications.



Only 115 patients were included (BMI 54.3 ± 8.7 kg/m2), of which 55 underwent IGB insertion. The proportion of patients who stayed in ICU >24 h was similar in both groups (P = 0.87). At M6, weight loss was significantly greater in the IGB group than in the SMC group (P < 0.0001). Three severe complications occurred during IGB removal. Mean operative time for LGBP was similar in both groups (P = 0.49). Five patients had 1 or more surgical complications, all in the IGB group (P = 0.02). Both groups had similar hospitalization stay (P = 0.59) and weight loss at M12 (P = 0.31).



IGB insertion before LGBP induced weight loss but did not improve the perioperative outcomes or affect postoperative weight loss.
AP-HP Hopital Louis Mourier, Colombes, France. benoit.coffin@aphp.fr.|Université Denis Diderot-Paris 7, Paris, France. benoit.coffin@aphp.fr.
B
0000-0002-0606-4158
B
Coffin
CHU Lille, Lille, France.|Université Lille-2, Lille, France.
V
V
Maunoury
CHU Lille, Lille, France.|Université Lille-2, Lille, France.
F
F
Pattou
Hopital de l'Archet, Nice, France.|Université de Nice, Nice, France.
X
X
Hébuterne
Hopital de l'Archet, Nice, France.|Université de Nice, Nice, France.
S
S
Schneider
AP-HP Hopital Louis Mourier, Colombes, France.|Université Denis Diderot-Paris 7, Paris, France.
M
M
Coupaye
AP-HP Hopital Louis Mourier, Colombes, France.|Université Denis Diderot-Paris 7, Paris, France.
S
S
Ledoux
AP-HP Hopital Louis Mourier, Colombes, France.|Université Denis Diderot-Paris 7, Paris, France.
F
F
Iglicki
Hospices Civils de Lyon, Lyon, France.|Université Lyon 1, Lyon, France.
F
F
Mion
Hospices Civils de Lyon, Lyon, France.|Université Lyon 1, Lyon, France.
M
M
Robert
Hospices Civils de Lyon, Lyon, France.|Université Lyon 1, Lyon, France.
E
E
Disse
CHU de Toulouse Rangueil, Toulouse, France.|Université Toulouse, Toulouse, France.
J
J
Escourrou
CHU de Toulouse Rangueil, Toulouse, France.|Université Toulouse, Toulouse, France.
G
G
Tuyeras
CHU Caen, Caen, France.
Y
Y
Le Roux
CHU de Grenoble and Faculté de Médecine de Grenoble, Grenoble, France.|Université Joseph Fournier, Grenoble, France.
C
C
Arvieux
CHU de Nîmes, Nîmes, France.|Université de Nîmes, Nîmes, France.
P
P
Pouderoux
CHU de Tours, France, France.|Université de Tours, France, France.
N
N
Huten
AP-HP Hôpital Bichat, Paris, France.
T
T
Alfaiate
AP-HP Hôpital Bichat, Paris, France.
D
D
Hajage
AP-HP Hopital Louis Mourier, Colombes, France.|Université Denis Diderot-Paris 7, Paris, France.
S
S
Msika
D000328:Adult; D015992:Body Mass Index; D003131:Combined Modality Therapy; D005260:Female; D015905:Gastric Balloon; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D015431:Weight Loss
Bridge therapy; Complications; Gastric balloon; Gastric bypass; Morbid obesity
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