Weiner Rudolf A, Pomhoff Ingmar, Schramm Markus, Weiner Sylvia, Blanco-Engert Rafael
Department of Surgery, Krankenhaus Sachsenhausen-Frankfurt, Germany.
Surg Technol Int. 2004;13:79-90.
The prevalence of obesity in the United States (U.S.) is increasing to epidemic proportions. Currently, more than 60% of Americans and 51% of Germans are overweight. Whereas a variety of medications are available for treatment of obesity, none results in the long-term loss of more than 10% of body weight. The current standard for treatment of severe obesity, defined as a body mass index (BMI) of greater than 35 kg/m2 with comorbidities and generally greater than 40 kg/m2, is surgical. Several surgical procedures are currently available, including gastric bypass, biliopancreatic diversion (BPD) with duodenal switch, and the adjustable gastric band. These operations may be performed using laparoscopic surgical techniques to minimize perioperative morbidity and postoperative recovery time. To optimize the outcome of this type of procedure, bariatric surgery should be performed on carefully selected patients, in bariatric centers specially equipped to care for the obese, within a broadly based, multidisciplinary setting that provides lifelong postoperative care.
美国肥胖症的患病率正上升至流行程度。目前，超过60%的美国人以及51%的德国人超重。尽管有多种药物可用于治疗肥胖症，但没有一种能使体重长期减轻超过10%。对于严重肥胖症（定义为体重指数（BMI）大于35 kg/m²且伴有合并症，一般大于40 kg/m²）的当前治疗标准是手术治疗。目前有几种手术方法，包括胃旁路手术、十二指肠转位的胆胰分流术（BPD）以及可调节胃束带术。这些手术可采用腹腔镜手术技术进行，以尽量减少围手术期发病率和术后恢复时间。为了优化这类手术的效果，减肥手术应在精心挑选的患者身上进行，在专门配备以照顾肥胖患者的减肥中心进行，且处于提供终身术后护理的广泛的多学科环境中。
