Melissas J, Christodoulakis M, Schoretsanitis G, Sanidas E, Ganotakis E, Michaloudis D, Tsiftsis D D
Bariatric Unit, Department of Surgical Oncology, University Hospital, Medical School, University of Crete, Heraklion, Crete, Greece.
Obes Surg. 2001 Aug;11(4):475-81. doi: 10.1381/096089201321209378.
The amount of excess weight which must be lost in order to cure or to improve disorders associated with obesity remains unknown. This study was designed to compare super obese and morbidly obese patients in terms of weight reduction following VBG and to investigate the effects of postoperative weight changes to preexisting co-morbidities.
125 patients underwent VBG. Group A consisted of 80 morbidly obese patients (64%) and group B consisted of 45 super obese patients (36%). Preoperative examination was planned to identify and determine the severity of any disorders associated with obesity, that the patients may have had. Following VBG, all patients were followed-up at regular time periods, for at least 2 and up to 4 years. The progress of preexisting co-morbidities was evaluated and carefully recorded.
Among the 80 patients of Group A, there were 240 total co-morbidities (3 per patient), and in group B there were 196 co-morbidities (4.35 per patient) preoperatively. Dyspnea during fatigue and arthritis were found at statistically higher incidence in the super obese category. At the end of the second postoperative year, greater weight loss in terms of number kilograms was seen in patients in group B, but these patients did not reach a BMI lower than 35, while patients in group A had mean BMI below 30. In group A, 66% of the co-morbidities completely resolved, 19% significantly diminished and 15% remain unchanged. In group B, the respective percentages were 53%, 27.5% and 19.5%. However, after weight reduction by VBG a significant number of co-morbidities remain in the super obese patients (92 or 2.044 per/patient), and this is believed to be due to the greater remaining excess weight.
Reduction of body weight by VBG is associated with resolution or improvement of a significant number of the obesity-associated disorders. However, super obese patients remain obese after surgery, and this results in two-fold higher remaining morbidity.
为治愈或改善与肥胖相关的疾病而必须减掉的多余体重数量尚不清楚。本研究旨在比较胃旁路手术（VBG）后超级肥胖患者和病态肥胖患者的体重减轻情况，并研究术后体重变化对术前并存疾病的影响。
125例患者接受了胃旁路手术。A组由80例病态肥胖患者（64%）组成，B组由45例超级肥胖患者（36%）组成。计划进行术前检查以识别和确定患者可能存在的与肥胖相关的任何疾病的严重程度。胃旁路手术后，所有患者定期随访至少2年，最长4年。评估并仔细记录术前并存疾病的进展情况。
A组80例患者术前共有240种并存疾病（平均每人3种），B组术前有196种并存疾病（平均每人4.35种）。在超级肥胖类别中，疲劳时呼吸困难和关节炎的发生率在统计学上更高。术后第二年末，B组患者在减重千克数方面减重更多，但这些患者的体重指数（BMI）未降至35以下，而A组患者的平均BMI低于30。在A组中，66%的并存疾病完全缓解，19%显著减轻，15%保持不变。在B组中，相应的百分比分别为53%、27.5%和19.5%。然而，胃旁路手术减重后，超级肥胖患者仍有大量并存疾病（92种或平均每人2.044种），这被认为是由于剩余的多余体重更多。
胃旁路手术减重与大量肥胖相关疾病的缓解或改善有关。然而，超级肥胖患者术后仍处于肥胖状态，这导致剩余发病率高出两倍。
