Department of General Surgery of Changzheng Hospital affiliated to Naval Military Medical University, Shanghai, China.
Department of General Surgery of Changzheng Hospital affiliated to Naval Military Medical University, Shanghai, China.
Surg Obes Relat Dis. 2019 Oct;15(10):1861-1871. doi: 10.1016/j.soard.2019.06.022. Epub 2019 Jun 28.
Obesity is a severe medical problem endangering the health of individuals worldwide. Sleeve gastrectomy (SG), one of the most commonly performed bariatric procedures, has been widely applied to the treatment of such patients. Currently, the potential mechanisms underlying the significant weight loss and metabolic improvement after SG have been well studied. First, and most importantly, by removing a large volume of stomach, the SG directly or indirectly restricts food intake. Then, there are alterations in the absorption and metabolism of both macro- and micronutrients, which may benefit or worsen the patients' well-being. Another profound change is enhanced secretion of the satiety gut hormone and reduced secretion of the hunger hormone as a consequence of the operation. Additionally, adjustment of gastrointestinal motility, alteration in the gut microbial community, and an inflammatory response were found after surgery. Therefore, the purpose of the present review was focused on such hypotheses and to compile the accumulated facts on the physiologic mechanism of bariatric surgery so that these results can help improve the understanding of how SG produces substantial weight loss and a significant improvement in the metabolism of patients with metabolic syndrome.
肥胖是一个严重的医学问题，威胁着全球人类的健康。袖状胃切除术（SG）是最常进行的减肥手术之一，已广泛应用于此类患者的治疗。目前，SG 后体重显著减轻和代谢改善的潜在机制已得到充分研究。首先，也是最重要的，通过切除大量胃，SG 直接或间接限制了食物摄入。然后，宏量和微量营养素的吸收和代谢发生改变，这可能对患者的健康有益或有害。另一个深刻的变化是手术导致饱腹感肠道激素分泌增加和饥饿激素分泌减少。此外，手术后发现胃肠道动力的调整、肠道微生物群落的改变和炎症反应。因此，本综述的目的是集中讨论这些假说，并汇编关于减肥手术生理机制的累积事实，以便这些结果有助于更好地理解 SG 如何产生显著的体重减轻和代谢综合征患者的代谢改善。
