Second Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, Thessaloniki, Greece.
Obes Rev. 2011 Jul;12(7):515-24. doi: 10.1111/j.1467-789X.2010.00831.x. Epub 2011 Feb 23.
Morbid obesity is associated with increased morbidity and represents a major healthcare problem with increasing incidence worldwide. Bariatric surgery is considered an effective option for the management of morbid obesity. We searched MEDLINE, Current Contents and the Cochrane Library for papers published on bariatric surgery in English from 1 January 1990 to 20 July 2010. We also manually checked the references of retrieved articles for any pertinent material. Bariatric surgery results in resolution of major comorbidities including type 2 diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, non-alcoholic fatty liver disease, nephropathy, left ventricular hypertrophy and obstructive sleep apnea in the majority of morbidly obese patients. Through these effects and possibly other independent mechanisms bariatric surgery appears to reduce cardiovascular morbidity and mortality. Laparoscopic Roux-en-Y gastric bypass (LRYGB) appears to be more effective than laparoscopic adjustable gastric banding (LAGB) in terms of weight loss and resolution of comorbidities. Operation-associated mortality rates after bariatric surgery are low and LAGB is safer than LRYGB. In morbidly obese patients bariatric surgery is safe and appears to reduce cardiovascular morbidity and mortality.
病态肥胖与发病率增加相关,并代表了一个日益严重的主要医疗保健问题。减重手术被认为是病态肥胖管理的有效选择。我们检索了 1990 年 1 月 1 日至 2010 年 7 月 20 日发表的英文减重手术文献,检索了 MEDLINE、Current Contents 和 Cochrane Library。我们还手动查阅了检索文章的参考文献,以获取任何相关资料。减重手术可使大多数病态肥胖患者的主要合并症得到解决,包括 2 型糖尿病、高血压、血脂异常、代谢综合征、非酒精性脂肪性肝病、肾病、左心室肥厚和阻塞性睡眠呼吸暂停。通过这些作用和可能的其他独立机制,减重手术似乎降低了心血管发病率和死亡率。腹腔镜 Roux-en-Y 胃旁路术(LRYGB)在减轻体重和解决合并症方面似乎比腹腔镜可调胃束带术(LAGB)更有效。减重手术后的手术相关死亡率较低,LAGB 比 LRYGB 更安全。在病态肥胖患者中,减重手术是安全的,并且似乎降低了心血管发病率和死亡率。
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