Department of Clinical Dietetics, Medical University of Warsaw, Poland.
Pol Przegl Chir. 2021 Mar 12;93(2):53-58. doi: 10.5604/01.3001.0014.7953.
Bariatric surgery is the most effective method of weight reduction among patients suffering from morbid obesity. Reduction of body weight before surgery is an important element. The aim of the study was to present the current knowledge on preoperative weight reduction and diet for this purpose.
To achieve the aims of the paper, articles available in the PubMed / MEDLINE database published in 2005-2020 were used, as well as the guidelines of societies such as Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons, American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery, International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter and European Association for the Study of Obesity.
Studies show that even a modest reduction in weight in the early preoperative period facilitates surgery and reduces the number of complications. The available data do not support the effect of preoperative weight loss on increased postoperative weight loss. The use of balanced, energy-restricted diet in the preoperative period prepares the patient for changes in the way of nutrition, which improves the nutritional status of patient. Low calorie (LCD) or very low calorie (VLCD) diet can be an effective method of weight loss before surgery, however, this approach does not allow to modify eating habits. The use of a very low calorie ketogenic diet (VLCKD) remains under discussion.
There is a need for large randomized trials to assess short and long term benefits of preoperative weight loss and methods of weight loss among patients qualified for bariatric surgery, also the standardization of nutritional management in the preoperative period.
减重手术是肥胖症患者中最有效的减重方法。手术前减轻体重是一个重要因素。本研究旨在介绍目前用于此目的的术前减重和饮食方面的知识。
为了实现本文的目的，使用了 2005 年至 2020 年期间在 PubMed/MEDLINE 数据库中可用的文章，以及波兰外科医生协会代谢和减重外科分会、美国临床内分泌医师协会、肥胖协会和美国代谢与减重外科学会、国际肥胖和代谢紊乱外科学会-欧洲分会和欧洲肥胖研究协会等学会的指南。
研究表明，即使在术前早期体重适度减轻也有助于手术并减少并发症的发生。现有数据并不支持术前体重减轻对术后体重增加的影响。在术前期间使用均衡、能量限制的饮食可以使患者为营养方式的改变做好准备，从而改善患者的营养状况。低热量（LCD）或极低热量（VLCD）饮食可以是手术前有效的减重方法，但这种方法不能改变饮食习惯。非常低卡路里生酮饮食（VLCKD）的使用仍在讨论中。
需要进行大规模随机试验，以评估肥胖症患者术前减重和减重方法的短期和长期益处，以及术前期间营养管理的标准化。
