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为肾移植做准备的肥胖症患者行减肥手术——病例报告

Bariatric surgery in morbidly obese patients with chronic renal failure, prepared for kidney transplantation--case reports.

作者信息

Proczko Monika, Kaska Łukasz, Kobiela Jarek, Stefaniak Tomasz, Zadrożny Dariusz, Śledziński Zbigniew

出版信息

Pol Przegl Chir. 2013 Jul;85(7):407-11. doi: 10.2478/pjs-2013-0062.

Abstract

Recent years, obesity is a growing health problem also in patients with chronic renal failure and end it's end stage. This situation has a negative impact both on the extension of the waiting period for transplantation, and the survival rate of the transplanted organ and the recipient. Weight loss through lifestyle modification before transplantation is ambiguous. Its well known fact of rapid body mass gain after transplantation, and finally the results of transplantation are not better than those of patients who have not reduced body weight. The paper presents preliminary experience associated with bariatric operations of three chronic dialysed patients with morbid obesity BMI> 35 kg/m², all patients had been treated by Roux-en-Y gastric by-pass (RYGB). All operated patients were classified as potential recipients were listed by Poltransplant. One of them three months after RYGB surgery underwent without complications a renal transplantation. Preliminary experiences based on operating these three case confirmed the complete safety of this type of approach in patients with end-stage chronic kidney disease (CKD).

摘要

近年来,肥胖在慢性肾衰竭及其终末期患者中也日益成为一个健康问题。这种情况对移植等待期的延长、移植器官及受者的存活率均有负面影响。移植前通过改变生活方式减重的效果并不明确。众所周知,移植后体重会迅速增加,最终移植结果并不优于未减重的患者。本文介绍了3例病态肥胖(BMI>35kg/m²)的慢性透析患者接受减重手术的初步经验,所有患者均接受了 Roux-en-Y 胃旁路术(RYGB)治疗。所有接受手术的患者均被列为潜在受者,并被波兰移植协会列入名单。其中1例患者在RYGB手术后3个月顺利接受了肾移植,未出现并发症。基于这3例病例的手术初步经验证实了这种方法在终末期慢性肾病(CKD)患者中的完全安全性。

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