Maleckas Almantas, Gudaitytė Rita, Petereit Rūta, Venclauskas Linas, Veličkienė Džilda
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania;; Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Gland Surg. 2016 Dec;5(6):617-624. doi: 10.21037/gs.2016.12.02.
Roux-en-Y gastric bypass (RYGB) is one of the most common operations performed for the patients with morbid obesity. Weight regain (WR) is a complication that may decrease efficiency of the surgical treatment and demand further interventions. Different factors including lifestyle, mental health, hormonal/metabolic and surgical plays role in WR after RYGB. Various treatment options have been proposed for WR. Conservative treatment is less effective than surgery. Endoscopic refashioning of gastric pouch/stoma fails to achieve sustainable weight loss. Surgical reduction of pouch has acceptable short-term results, but WR after 3 years is substantial. Banded gastric bypass achieves good short-term results, but long-term follow-up data are needed. Distalization of RYGB has a high risk of protein calorie malnutrition (PCM) and conversion to BP diversion (BPD)/duodenal switch (DS) is a technically demanding procedure. Both procedures achieve sustainable long-term weight loss. More studies are needed to explore long-term results of various surgical interventions for WR after RYGB.
Roux-en-Y胃旁路术（RYGB）是为病态肥胖患者实施的最常见手术之一。体重反弹（WR）是一种并发症，可能会降低手术治疗的效果，并需要进一步干预。包括生活方式、心理健康、激素/代谢和手术等不同因素在RYGB术后的体重反弹中起作用。针对体重反弹已提出了各种治疗方案。保守治疗不如手术有效。胃囊/吻合口的内镜重塑未能实现可持续的体重减轻。胃囊手术缩小在短期内效果尚可，但3年后的体重反弹情况较为严重。带环胃旁路术取得了良好的短期效果，但需要长期随访数据。RYGB远端化有较高的蛋白质热量营养不良（PCM）风险，而转换为胆胰转流术（BPD）/十二指肠转位术（DS）是一项技术要求较高的手术。这两种手术都能实现可持续的长期体重减轻。需要更多研究来探索RYGB术后体重反弹的各种手术干预的长期效果。
