Müller M K, Wildi S, Clavien P-A, Weber M
Klinik für Viszeral- und Transplantationschirurgie, Universitätsspital Zürich, Schweiz.
Chirurg. 2005 Jul;76(7):658-67. doi: 10.1007/s00104-005-1050-x.
Bariatric surgery is currently considered the best treatment option for morbid obesity. With the rapid development of laparoscopic techniques, a significant increase in the number bariatric procedures in recent years can be observed. Various surgical techniques to treat morbid obesity have been described, but only few prospective studies compare the different procedures, leading to a lack of evidence for their use. However, from the available literature some general recommendations can be given: (a) preoperative workup in an interdisciplinary team is mandatory, (b) primary bariatric procedures should be performed laparoscopically, and (c) the combination of restrictive and malabsorptive techniques is more efficient than a purely restrictive method, which is also true for the treatment of comorbid diabetes and arterial hypertension. In this paper, we present recent developments in bariatric surgery, with special emphasis on the available evidence for the best treatment of morbidly obese patients.
目前，减肥手术被认为是治疗病态肥胖的最佳选择。随着腹腔镜技术的迅速发展，近年来减肥手术的数量显著增加。已经描述了各种治疗病态肥胖的手术技术，但只有少数前瞻性研究比较了不同的手术方法，导致缺乏使用这些方法的证据。然而，从现有文献中可以给出一些一般性建议：（a）必须在跨学科团队中进行术前检查，（b）原发性减肥手术应通过腹腔镜进行，（c）限制性和吸收不良性技术相结合比单纯的限制性方法更有效，这在治疗合并糖尿病和动脉高血压时也是如此。在本文中，我们介绍了减肥手术的最新进展，特别强调了治疗病态肥胖患者最佳方法的现有证据。
