De Cesare Alessandro, Cangemi Barbara, Fiori Enrico, Bononi Marco, Cangemi Roberto, Basso Luigi
Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Faculty of Medicine and Dentistry, viale del Policlinico 155, 00161, Rome, Italy.
Surg Today. 2014 Aug;44(8):1424-33. doi: 10.1007/s00595-014-0856-x. Epub 2014 Feb 12.
To evaluate the early and long-term postoperative results of malabsorptive surgery in morbidly obese patients.
Between 2000 and 2007, 102 morbidly obese patients were referred to the Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Policlinico "Umberto I°", Rome, Italy for malabsorptive surgery. All patients underwent derivative biliodigestive surgery after they had been reviewed by a team of surgeons, physicians, dieticians, and psychologists.
There were no intra-operative complications, but two patients suffered postoperative pulmonary embolisms, which resolved with medical treatment. The mean postoperative hospital stay was 7 days, with no early or late mortality. Maximum weight loss was reached 12-24 months after surgery, while the mean percentage excess weight loss at 3-5 years ranged from 45 to 64 %. Specific postoperative complications in the first 2 years after surgery were abdominal abscess (n = 2), gastroduodenal reflux (n = 4), and incisional hernia (n = 6). Diabetes resolved in 98 % of the diabetic patients within a few weeks after surgery and blood pressure normalised in 86.4 % of those who had had hypertension preoperatively. Obstructive sleep apnoea and obesity hypoventilation syndrome also improved significantly in 92 % of the patients.
Morbidly obese patients can undergo biliodigestive surgery safely with good long-term weight loss and quality of life expectancy.
评估病态肥胖患者吸收不良手术后的早期和长期结果。
2000年至2007年间，102例病态肥胖患者被转诊至意大利罗马“皮埃特罗·瓦尔托尼”外科、罗马第一大学“萨皮恩扎”大学、罗马“翁贝托一世”综合医院接受吸收不良手术。所有患者在经过外科医生、内科医生、营养师和心理学家团队评估后均接受了胆汁消化分流手术。
术中无并发症，但有2例患者术后发生肺栓塞，经药物治疗后痊愈。术后平均住院时间为7天，无早期或晚期死亡病例。术后最大体重减轻在术后12 - 24个月达到，3 - 5年时平均超重减轻百分比在45%至64%之间。术后前2年的特定并发症包括腹部脓肿（n = 2）、胃十二指肠反流（n = 4）和切口疝（n = 6）。98%的糖尿病患者在术后几周内糖尿病得到缓解，术前患有高血压的患者中86.4%血压恢复正常。92%的患者阻塞性睡眠呼吸暂停和肥胖低通气综合征也有显著改善。
病态肥胖患者可以安全地接受胆汁消化分流手术，长期减重效果良好，预期寿命质量较高。
