Bariatric endoscopic antral myotomy: a pilot study assessing technical feasibility, physiologic changes, and preliminary efficacy

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastrointestinal endoscopy Pub Date : 2024-10-01 DOI:10.1016/j.gie.2024.04.2925

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Abstract

Background and Aims

Gastric balloons and endoscopic sleeve gastroplasty appear to work by delaying gastric emptying. We hypothesized that pylorus-sparing antral myotomy would inhibit the antral pump, inducing gastric retention and similarly resulting in weight loss.

Methods

In this single-center pilot study, we assessed bariatric endoscopic antral myotomy (BEAM) using submucosal tunneling. The primary outcomes were feasibility, safety, and efficacy at 6 and 12 months, whereas the secondary outcomes were changes in the gastric-emptying rate and gastroparesis cardinal symptom index (GCSI) score.

Results

Six subjects underwent successful BEAM. One required needle decompression, and another developed pulmonary embolism, treated without sequela. At 6 and 12 months, patients achieved 9.1% ± 8.9% and 12.2% ± 7.1% total weight loss (P < .0005). The gastric-emptying rate was delayed by 36.6% in those with ≥10% total weight loss. The GCSI score increased significantly at 12 months, particularly regarding early satiety.

Conclusions

This pilot study suggests BEAM is feasible and appears to induce delayed gastric emptying that is associated with significant weight loss, without symptoms of gastroparesis.

Abstract Image

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减肥内窥镜前胃肌切开术：评估技术可行性、生理变化和初步疗效的试点研究。

背景和目的：胃球囊和内镜袖状胃成形术似乎通过延迟胃排空而发挥作用。我们假设，幽门保留窦前肌切开术将抑制窦前泵诱发胃潴留，并同样导致体重减轻：方法：单中心试点研究，评估通过粘膜下隧道进行的减肥内镜下胃前区肌切开术（BEAM）。主要结果包括可行性、安全性以及 6 个月和 12 个月的疗效。次要结果包括胃排空率和 GCSI 评分的变化：六名受试者成功接受了 BEAM。一名患者需要进行针孔减压，另一名患者出现肺栓塞，治疗后无后遗症。在 6 个月和 12 个月时，患者的 TWL 分别为 9.1±8.9% 和 12.2±7.1%（PC结论：这项试验性研究表明，BEAM 是一种有效的治疗方法：这项试点研究表明，BEAM 是可行的，而且似乎可以诱导胃排空延迟，从而显著减轻体重，但不会出现胃瘫症状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.