Bende János, Csiszár Miklós, Ursu Miklós
Péterfy Sándor utcai Kórház, Sebészeti és Plasztikai Sebészeti Osztály, Budapest.
Orv Hetil. 2003 Dec 14;144(50):2459-63.
The incidence of obesity keeps increasing in the developed countries. This tendency can be observed also in Hungary. According to scientific literature the extremely obese patients die 12 times more often than ones with normal body weights in the same age. Even with the most thoroughly planned, performed and medicine supported diets it is impossible to achieve a weight loss of more than 10-15 kg. Thus it is the surgical solution from which more and more people around the world expect promising and permanent results. Only in Europe 30 thousand gastric band operations were performed in the last 6 years.
The surgical treatment of extreme obesity has gone through tremendous improvement in the past 10 years. In the articles the authors describe the most often performed surgical procedures. They list and evaluate the used methods in the treatment of extreme obesity from the modern stomach reduction operations to the various bypass procedures.
The authors also give a report on their 54 operations performed in the last 4 years and also on the achieved results. During this period they have mounted 52 gastric bands with laparoscopic procedures and performed 2 vertical gastric band operations. No deadly or life threatening complications have occurred in any cases. Four of their patients with the best weight loss results have lost an average of 116 kg in 18 months. The patients' diabetes, hypertension, sleeping apnea and other diseases have partially or completely disappeared after the loss of 25% of the body weight.
The authors believe that the application of adjustable gastric bands is a more humane and more physiological solution than the practically irreversible resection and bypass operations. The authors state that depending on the patients' cooperation the modern surgical solutions give a real chance of significant weight loss. They help to cure the additional diseases and assist the re-socialization of the patient as well. Based on their own and literature data the authors claim that the surgical treatment--with acceptable risk--helps the rehabilitation of the patients and significantly improves their quality of life.
肥胖症在发达国家的发病率持续上升。匈牙利也呈现出这种趋势。根据科学文献，极度肥胖患者的死亡率比同年龄段正常体重者高出12倍。即便采用最精心规划、执行并辅以药物支持的饮食方案，体重减轻也很难超过10 - 15千克。因此，手术治疗方案受到了全球越来越多人的期待，他们希望借此获得显著且持久的效果。仅在欧洲，过去六年就进行了3万例胃束带手术。
在过去十年中，极端肥胖症的外科治疗取得了巨大进展。在本文中，作者描述了最常实施的外科手术程序。他们列举并评估了从现代胃减容手术到各种旁路手术等用于治疗极端肥胖症的方法。
作者还报告了他们在过去四年中进行的54例手术及取得的成果。在此期间，他们通过腹腔镜手术安装了52个胃束带，并进行了2例垂直胃束带手术。所有病例均未出现致命或危及生命的并发症。体重减轻效果最佳的4例患者在18个月内平均减重116千克。患者体重减轻25%后，其糖尿病、高血压、睡眠呼吸暂停及其他疾病部分或全部消失。
作者认为，与几乎不可逆转的切除和旁路手术相比，应用可调节胃束带是一种更人道、更符合生理的解决方案。作者指出，取决于患者的配合程度，现代手术方案确实能让患者有机会大幅减重。它们有助于治愈其他疾病，还能协助患者重新融入社会。基于自身及文献数据，作者宣称手术治疗在可接受的风险范围内有助于患者康复，并显著提高其生活质量。
