Ri Motonari, Aikou Susumu, Seto Yasuyuki
Department of Gastrointestinal Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan.
Ann Gastroenterol Surg. 2017 Oct 28;2(1):13-21. doi: 10.1002/ags3.12049. eCollection 2018 Jan.
In recent years, both the actual number of overweight/obese individuals and their proportion of the population have steadily been rising worldwide and obesity-related diseases have become major health concerns. In addition, as obesity is associated with an increased incidence of gastroenterological cancer, the number of obese patients has also been increasing in the field of gastroenterological surgery. While the influence of obesity on gastroenterological surgery has been widely studied, very few reports have focused on individual organs or surgical procedures, using a cross-sectional study design. In the present review, we aimed to summarize the impacts of obesity on surgeries for the esophagus, stomach, colorectum, liver and pancreas. In general, obesity prolongs operative time. As to short-term postoperative outcomes, obesity might be a risk for certain complications, depending on the procedure carried out. In contrast, it is possible that obesity doesn't adversely impact long-term surgical outcomes. The influences of obesity on surgery are made even more complex by various categories of operative outcomes, surgical procedures, and differences in obesity among races. Therefore, it is important to appropriately evaluate perioperative risk factors, including obesity.
近年来,全球超重/肥胖个体的实际数量及其在总人口中的比例一直在稳步上升,与肥胖相关的疾病已成为主要的健康问题。此外,由于肥胖与胃肠癌发病率的增加有关,肥胖患者在胃肠外科领域的数量也在不断增加。虽然肥胖对胃肠外科手术的影响已得到广泛研究,但很少有报告采用横断面研究设计关注单个器官或手术操作。在本综述中,我们旨在总结肥胖对食管、胃、结直肠、肝脏和胰腺手术的影响。一般来说,肥胖会延长手术时间。至于术后短期结果,根据所进行的手术,肥胖可能是某些并发症的风险因素。相比之下,肥胖可能不会对手术长期结果产生不利影响。肥胖对手术的影响因各类手术结果、手术操作以及不同种族间肥胖差异而变得更加复杂。因此,适当评估包括肥胖在内的围手术期风险因素非常重要。