Cossu M L, Coppola M, Fais E, Ruggiu M, Noya G
Cattedra di Chirurgia d'Urgenza, Università degli Studi, Sassari.
Minerva Chir. 2000 Apr;55(4):211-9.
The aim of this study was to evaluate the results obtained using Scopinaro's biliopancreatic diversion technique (AHS-BPD) in the surgical treatment of morbid obesity.
A retrospective study was carried out in 69 patients with a follow-up ranging between 6-44 months. All patients were operated and monitored by the Obesity Surgery Centre operating in Sardinia since february 1995 at the Department of Emergency Surgery of Sassari University. All the patients were severely obese with a mean BMI of 51.58 and, in the majority of cases, presented associated metabolic diseases with the following incidence: type 2 diabetes in 40.57%, arterial hypertension in 36.23%, severe alteration of lipid status in 52.17%; in overall terms, a plurimetabolic syndrome was present in 24.63% of cases. All patients underwent biliopancreatic diversion using Scopinaro's classic technique (AHS-BPD). Controls were carried out at set intervals (1-3-6-12-18 and 24 months) to evaluate weight loss and the metabolic effects of surgery in terms of the lipid, glucose and protein status.
Results were good, as confirmed by the marked weight loss (BMI after 24 months: 30) and the normalisation of cholesterol and glycemia. No major reductions were observed in proteinemia and albuminemia levels.
In the light of these results, the authors affirm that Scopinaro's technique is a valid solution for the treatment of morbid obesity. Its relatively invasive nature is justified by the results obtained in terms of weight control and its effect on associated metabolic diseases.
本研究旨在评估使用斯科皮纳罗胆胰转流术(AHS - BPD)治疗病态肥胖症的手术效果。
对69例患者进行了一项回顾性研究,随访时间为6至44个月。自1995年2月起,所有患者均由撒丁岛肥胖手术中心在萨萨里大学急诊外科进行手术并接受监测。所有患者均为重度肥胖,平均体重指数(BMI)为51.58,且在大多数情况下伴有以下发病率的相关代谢疾病:2型糖尿病占40.57%,动脉高血压占36.23%,血脂严重异常占52.17%;总体而言,24.63%的病例存在多代谢综合征。所有患者均采用斯科皮纳罗经典技术(AHS - BPD)进行胆胰转流术。定期(1、3、6、12、18和24个月)进行对照检查,以评估体重减轻情况以及手术在脂质、血糖和蛋白质状态方面的代谢效果。
结果良好,显著的体重减轻(24个月后BMI为30)以及胆固醇和血糖正常化证实了这一点。未观察到蛋白血症和白蛋白血症水平有重大降低。
鉴于这些结果,作者断言斯科皮纳罗技术是治疗病态肥胖症的有效解决方案。其相对较高的侵入性因其在体重控制方面取得的结果及其对相关代谢疾病的影响而具有合理性。