Botella Romero Francisco, Milla Tobarra Marta, Alfaro Martínez José Joaquín, García Arce Llanos, García Gómez Angélica, Salas Sáiz M Ángeles, Soler Marín Antonio
Sección de Endocrinología y Nutrición, SESCAM, Hospital General Universitario de Albacete, Albacete, España.
Endocrinol Nutr. 2011 May;58(5):214-8. doi: 10.1016/j.endonu.2011.02.008. Epub 2011 Apr 27.
Bariatric surgery using the technique of duodenal switch is considered as one of the most effective treatments to lose weight and decrease comorbidity in morbidly obese patients. However, we have to be familiar with and adequately manage the various nutritional deficiencies that may occur as a consequence of its practice.
To assess weight loss and development of nutritional deficiencies in morbidly obese patients undergoing bariatric surgery through the duodenal switch procedure.
One hundred and twenty-eight morbidly obese patients underwent a duodenal switch procedure at Hospital General Universitario in Albacete. Weight changes and the most important nutritional deficiencies occurring after surgery were recorded.
Median follow-up time was 30 months (interquartile range, 18 months). Body weight markedly decreased, with mean body mass index (BMI) decreasing from a preoperative value of 52.9±7.7kg/m(2) to 30.8±5.2kg/m(2) 18 months after surgery. The percentage of excess weight lost (% EWL) was 81.4±16.4% in this period. Weight loss slowed down subsequently, reaching its lowest value 30 months after surgery (% EWL 82.1%±16.8, BMI 30.2±4.3kg/m(2)) and tended to stabilize in patients with longer follow-up times. Significant nutritional deficiencies requiring replacement therapy were detected in some micronutrients with iron (42.9%), zinc (38.3%), vitamin A (55.5%), and vitamin D (57.8%) deficiencies being most relevant.
Duodenal switch is a very effective surgical procedure for treating morbidly obese patients because it allows for achieving a significant and sustained weight loss.Close lifetime monitoring is required in these patients because of the high prevalence of nutritional deficiencies during follow-up.
采用十二指肠转位术的减肥手术被认为是病态肥胖患者减肥及降低合并症的最有效治疗方法之一。然而，我们必须熟悉并妥善处理因实施该手术可能出现的各种营养缺乏问题。
通过十二指肠转位手术评估病态肥胖患者接受减肥手术后的体重减轻情况及营养缺乏的发展情况。
128例病态肥胖患者在阿尔巴塞特大学综合医院接受了十二指肠转位手术。记录术后体重变化及出现的最重要的营养缺乏情况。
中位随访时间为30个月（四分位间距为18个月）。体重显著下降，术后18个月时平均体重指数（BMI）从术前的52.9±7.7kg/m²降至30.8±5.2kg/m²。在此期间，多余体重减轻百分比（%EWL）为81.4±16.4%。随后体重减轻速度放缓，术后30个月降至最低值（%EWL 82.1%±16.8，BMI 30.2±4.3kg/m²），且在随访时间较长的患者中趋于稳定。在一些微量营养素中检测到需要替代治疗的显著营养缺乏情况，其中铁（42.9%）、锌（38.3%）、维生素A（55.5%）和维生素D（57.8%）缺乏最为突出。
十二指肠转位术是治疗病态肥胖患者的一种非常有效的手术方法，因为它能实现显著且持续的体重减轻。由于随访期间营养缺乏的发生率较高，这些患者需要终身密切监测。
