Department of Surgery, Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden.
Dig Dis. 2012;30(2):173-7. doi: 10.1159/000336674. Epub 2012 Jun 20.
Bariatric surgery is followed by substantial and durable weight loss and associated with it favorable metabolic effects far beyond those achieved by lifestyle modifications and pharmacological treatments. The perioperative and postoperative morbidity and mortality have decreased significantly over the years to the level that bariatric surgery now can compare with other frequently recommended and well-accepted procedures such as cholecystectomy and hysterectomy. In fact, the postoperative mortality risk of bariatric surgery is far lower than that of coronary artery bypass surgery but with significantly greater improvement in long-term mortality. Much of the improvement in perioperative morbidity and mortality can be attributed to advances in many components of the care chain such as the introduction of laparoscopic surgery, as well as establishment of a nationwide center of excellence network and required outcome reporting. Extensive evidence on safety and efficacy supports bariatric surgery as the standard of care for treatment of severe obesity. Bariatric surgery reduces the risk of global mortality, all-cause mortality and cardiovascular mortality when compared to obese control patients. Both gastric banding and gastric bypass seem to reduce mortality risk.
减重手术可带来显著且持久的体重减轻，并带来有利的代谢效果，远超生活方式改变和药物治疗所能达到的效果。多年来，减重手术的围手术期和术后发病率和死亡率已显著下降，其水平已可与胆囊切除术和子宫切除术等经常推荐且广泛接受的手术相媲美。事实上，减重手术的术后死亡率风险远低于冠状动脉旁路手术，但长期死亡率的改善幅度要大得多。围手术期发病率和死亡率的大部分改善可归因于护理链中许多方面的进步，如腹腔镜手术的引入，以及建立全国卓越中心网络和要求报告结果。大量关于安全性和有效性的证据支持将减重手术作为治疗严重肥胖的标准护理。与肥胖对照患者相比，减重手术可降低全因死亡率和心血管死亡率的发生风险。胃束带术和胃旁路术似乎都能降低死亡风险。
