Department of Abdominal Surgery, University Hospitals, Leuven, Belgium.
Department of Abdominal Surgery, AZ Sint Jan, Bruges, Belgium.
Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):159-73. doi: 10.1016/j.bpg.2013.11.013. Epub 2013 Dec 6.
Recently obesity has been defined as a disease and has turned bariatric surgery into a part of a chronic illness management. Obesity induces several comorbidities leading to cardiovascular disease and mortality. The effects of bariatric surgery on these comorbidities used to be classified as weight-loss induced. However bariatric surgery has recently been termed metabolic surgery because of the suspected direct, weight loss independent effect of bariatric procedures on the physiopathological mechanisms causing excess fat storage and insulin resistance. This review describes the standard procedures commonly performed and their specific outcomes on metabolic diseases in order to work towards more patient tailored treatment of obesity and to reduce side effects. Furthermore this review focuses on gaps in understanding the pathogenesis of obesity and its treatment with bariatric surgery. Surgery failures as well as new techniques are discussed and evaluated.
最近，肥胖已被定义为一种疾病，使减重手术成为慢性病管理的一部分。肥胖会引起多种合并症，导致心血管疾病和死亡。减重手术对这些合并症的影响过去被归类为减肥引起的。然而，由于减重手术对导致脂肪过度储存和胰岛素抵抗的病理生理机制可能存在直接的、与体重减轻无关的影响，因此最近它被称为代谢手术。本综述描述了通常进行的标准手术程序及其对代谢疾病的具体效果，旨在针对肥胖症进行更个体化的治疗，并减少副作用。此外，本综述还重点介绍了理解肥胖症及其用减重手术治疗的发病机制方面的差距。讨论和评估了手术失败和新技术。
