Bariatric and Metabolic Institute, M61 Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Surgeon. 2011 Oct;9(5):273-7. doi: 10.1016/j.surge.2011.04.002. Epub 2011 May 4.
Bariatric surgery is well established as a safe and effective treatment for morbid obesity and related metabolic diseases. As an elective procedure, it is critical that individuals considering bariatric surgery should be carefully selected, extensively evaluated, and optimized in order to achieve optimal outcomes. This patient population has unique and challenging issues, including an extensive range of potential medical, psychiatric, and psychological comorbidities, and often patients have unrealistic expectations of the surgery. Therefore, a multidisciplinary, comprehensive and timely assessment preoperatively is of great importance. Individual bariatric units utilise different preoperative patient evaluation protocols. There is at present no uniformly accepted or recommended practice. In this article we describe what we believe are the essential components of a preoperative bariatric surgery evaluation, with supporting evidence for each recommendation. We also present a protocol currently in practice at a high volume bariatric center of excellence; the Bariatric and Metabolic Institute in the Cleveland Clinic, Ohio.
减重手术已被广泛认可为治疗病态肥胖和相关代谢性疾病的安全有效的方法。作为一种选择性手术，对考虑接受减重手术的个体进行仔细选择、广泛评估和优化至关重要，以实现最佳结果。该患者群体具有独特且具有挑战性的问题，包括广泛的潜在医疗、精神和心理合并症，并且患者通常对手术抱有不切实际的期望。因此，术前进行多学科、全面和及时的评估非常重要。各个减重单位使用不同的术前患者评估方案。目前尚无被普遍接受或推荐的做法。本文我们描述了我们认为是术前减重手术评估的基本组成部分，并为每项建议提供了支持证据。我们还介绍了目前在俄亥俄州克利夫兰诊所的减重和代谢研究所这一卓越减重中心实践的方案。
