CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(01): E59-E63
DOI: 10.1055/s-0042-120413
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

The Obalon swallowable intragastric balloon in pediatric and adolescent morbid obesity

Francesco De Peppo
1   Department of Pediatric Surgery and Transplantation Center, Pediatric Surgery Unit, Bambino Gesù Children’s Hospital, Research Institute, Passoscuro, Rome, Italy
,
Romina Caccamo
2   Department of Pediatric Surgery and Transplantation Center, Hepato-Biliary Surgery Unit, Bambino Gesù Children’s Hospital, Research Institute, Passoscuro, Rome, Italy
,
Ottavio Adorisio
1   Department of Pediatric Surgery and Transplantation Center, Pediatric Surgery Unit, Bambino Gesù Children’s Hospital, Research Institute, Passoscuro, Rome, Italy
,
Emanuela Ceriati
2   Department of Pediatric Surgery and Transplantation Center, Hepato-Biliary Surgery Unit, Bambino Gesù Children’s Hospital, Research Institute, Passoscuro, Rome, Italy
,
Paola Marchetti
2   Department of Pediatric Surgery and Transplantation Center, Hepato-Biliary Surgery Unit, Bambino Gesù Children’s Hospital, Research Institute, Passoscuro, Rome, Italy
,
Antonio Contursi
3   Department of Pediatric Anesthesiology, Bambino Gesù Children’s Hospital, Research Institute, Passoscuro, Rome, Italy
,
Arianna Alterio
4   Hepato-Metabolic Disease Unit and Liver Research Unit, “Bambino Gesu”, Childrenʼs Hospital, IRCCS, Rome, Italy
,
Claudia Della Corte
4   Hepato-Metabolic Disease Unit and Liver Research Unit, “Bambino Gesu”, Childrenʼs Hospital, IRCCS, Rome, Italy
,
Malnia Manco
4   Hepato-Metabolic Disease Unit and Liver Research Unit, “Bambino Gesu”, Childrenʼs Hospital, IRCCS, Rome, Italy
,
Valerio Nobili
4   Hepato-Metabolic Disease Unit and Liver Research Unit, “Bambino Gesu”, Childrenʼs Hospital, IRCCS, Rome, Italy
› Author Affiliations
Further Information

Publication History

submitted 01 June 2016

accepted after revision 10 October 2016

Publication Date:
25 January 2017 (online)

Abstract

Background and study aims Incidence of morbid obesity has grown dramatically in the last half century and this phenomenon affects with particular severity the pediatric population. Dietary restrictions and careful programs to improve lifestyle are often ineffective to manage this particular group of patients, due to poor compliance typical of the adolescence. The aim of this study was to evaluate the effectiveness of a new intragastric balloon for treatment of morbidly obese children.

Patients and methods A new swallowable intragastric balloon (Obalon) has been used for the first time in 17 obese children in order to assess its safety and effectiveness in terms of reduction in excess weight. In 9 of 17 children a second balloon was placed 30 to 40 days after the first insertion. All devices were endoscopically removed after a mean time of 18 weeks.

Results In the group of 16 patients who completed the study (1 patient still under treatment) mean weight decreased from 95.8 ± 18.4 Kg to 83.6 ± 27.1 (P < 0.05). Mean body mass index (BMI) decreased from 35.27± 5.89 (range 30.4 – 48) to 32.25 ± 7.1 (range 23.5 – 45.7) (P > 0.05); mean excess weight, calculated according to Cole’s curves for pediatric populations, decreased from 36.2 ± 15.9 to 29.4 ± 18.3 Kg (P = 0.14), with an %EWL of 20.1 ± 9.8 (range 2.3 – 35.1). Waist circumference decreased from 109 ± 12.3 cm to 99 ± 10.5 cm (P < 0.05).

Conclusions Obalon can be administered easily without complications, inducing an appreciable weight loss with a statistically significant reduction in BMI and an improvement in associated comorbidities.

 
  • References

  • 1 Tauber M. Obesity and overweight of children and adolescents. Rev Prat 2015; 65: 1263
  • 2 Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 11-25
  • 3 Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007; 29: 62-76
  • 4 Skoczen S, Wojcik M, Fijorek K. et al. Expression of the central obesity and Type 2 Diabetes mellitus genes is associated with insulin resistance in young obese children. Exp Clin Endocrinol Diabetes 2015; 123: 252-259
  • 5 Vandenplas Y, Bollen P, De Langhe K. et al. Intragastric balloons in adolescents with morbid obesity. Eur J Gastroenterol Hepatol 1999; 11: 243-245
  • 6 Freedman DS, Mei Z, Srinivasan SR. et al. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr 2007; 150: 12-17 , e2
  • 7 Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years: 1979–1999. Pediatrics 2002; 109: E81-E86
  • 8 Inge TH, Krebs NF, Garcia VF. et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics 2004; 114: 217-223
  • 9 Cunneen SA. Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. Surg Obes Relat Dis 2008; 4: 47-55
  • 10 Nobili V, Corte CD, Liccardo D. et al. Obalon intragastric balloon in the treatment of paediatric obesity: a pilot study. Pediatr Obes 2015; 10: e1-4
  • 11 Genco A, Bruni T, Doldi SB. et al. BioEnterics Intragastric Balloon: The Italian Experience with 2,515 Patients. Obes Surg 2005; 15: 1161-1164
  • 12 Brooks JI, Srivastava ED, Mathus-Vliegen EM. One-year adjustable intragastric balloons: results in 73 consecutive patients in the U. K. Obes Surg 2014; 24: 813-819
  • 13 Genco 1 A, Dellepiane D, Baglio G. et al. Adjustable intragastric balloon vs non-adjustable intragastric balloon: case-control study on complications, tolerance, and efficacy. Obes Surg 2013; 23: 953-958
  • 14 De Peppo F, Di Giorgio G, Germani M. et al. BioEnterics intragastric balloon for treatment of morbid obesity in Prader-Willi syndrome: specific risks and benefits. Obes Surg 2008; 18: 1443-1449
  • 15 Kirby DF, Wade JB, Mills PR. et al. A prospective assessment of the Garren-Edwards Gastric Bubble and bariatric surgery in the treatment of morbid obesity. Am Surg 1990; 56: 575-580
  • 16 Fried M, Yumuk V, Oppert JM. et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg 2014; 24: 42-55