Castagneto Gissey Lidia, Casella Mariolo James Rossario, Mingrone Geltrude
Department of General Surgery, University of Rome "La Sapienza", Rome, Italy.
James Black Centre, King's College Hospital, Denmark Hill, SE5 9RS, London, UK.
Curr Atheroscler Rep. 2016 Jul;18(7):43. doi: 10.1007/s11883-016-0590-5.
Bariatric/metabolic surgery has proven to be effective in inducing and maintaining diabetes remission-although with a percentage of patients undergoing hyperglycemia relapse-weight loss, and improvement of the cardiovascular risk. It is, however, associated with mortality, although low, and early and late complications. In particular, metabolic complications are related to vitamin deficiency due to the erratic absorption of the supplemented vitamins and to the unpredictable compliance of patients to vitamin and trace element supplementation. In addition, often, the general practitioners and even the specialists are unaware of the clinical effects of metabolic dysfunction following malabsorptive surgery. The choice of the surgical procedure should be the balance between benefits and risks. Our review addresses this important question trying to give some suggestions.
减肥/代谢手术已被证明在诱导和维持糖尿病缓解方面是有效的——尽管有一定比例的患者会出现高血糖复发、体重减轻以及心血管风险改善。然而，它与死亡率相关，尽管死亡率较低，还会引发早期和晚期并发症。特别是，代谢并发症与维生素缺乏有关，这是由于补充维生素的吸收不稳定以及患者对维生素和微量元素补充的依从性不可预测。此外，通常全科医生甚至专科医生都未意识到吸收不良手术后代谢功能障碍的临床影响。手术方式的选择应权衡利弊。我们的综述探讨了这个重要问题并试图给出一些建议。
