Lodewijks Yentl, van der Ven Roos, Nienhuijs Simon
Department of Obesity Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
Clin Obes. 2022 Jun;12(3):e12518. doi: 10.1111/cob.12518. Epub 2022 Mar 15.
Additional preoperative programmes may be beneficial for candidates who seek bariatric surgery, but there is no consensus on the optimal preparation. This systematic review aimed to summarize the effects of a preoperative programme on weight loss. A literature search was performed for Embase, Cinahl, PubMed and Cochrane Library. Studies on preoperative exercise, behaviour and/or diet programmes administered in adult patients in a bariatric trajectory measuring weight loss were included. Initial results yielded 2148 titles, 70 of which were thoroughly analysed and 37 articles were included, comprising 10 333 patients. Eleven out of 37 studies included postoperative weight loss as an outcome in interventions focused on diet (n = 5), behaviour (n = 2), exercise (n = 2) and a combination of interventions (n = 2). Only one study (9%) which administered exercise as a preoperative programme showed a significant effect on postoperative weight loss. In total, 33 studies included preoperative weight loss as an outcome, which was significant in 64% of the cases. It is difficult to draw conclusions from the investigated data as it was extremely heterogeneous concerning the intensity, duration and administration of a programme. Nevertheless, it seems that a preoperative weight loss programme seems beneficial in terms of preoperative weight loss, postoperative physical activity and improved mental health postinterventional. The use of a core outcome set is recommended for future studies.
额外的术前方案可能对寻求减肥手术的患者有益，但对于最佳准备方案尚无共识。本系统评价旨在总结术前方案对体重减轻的影响。对Embase、Cinahl、PubMed和Cochrane图书馆进行了文献检索。纳入了对处于减肥进程中的成年患者实施的术前运动、行为和/或饮食方案以测量体重减轻的研究。初步检索结果得到2148个标题，其中70个进行了全面分析，37篇文章被纳入，共涉及10333名患者。37项研究中有11项将术后体重减轻作为干预措施（包括饮食干预5项、行为干预2项、运动干预2项以及综合干预2项）的结果。只有一项将运动作为术前方案的研究（9%）显示对术后体重减轻有显著效果。总共有33项研究将术前体重减轻作为结果，其中64%的情况显示有显著效果。由于所研究数据在方案的强度、持续时间和实施方面极其异质，因此很难从这些数据中得出结论。尽管如此，术前体重减轻方案似乎在术前体重减轻、术后身体活动和干预后心理健康改善方面是有益的。建议未来的研究使用核心结局指标集。
