Royal Canadian Medical Services, Canadian Armed Forces, Ottawa, Ontario, Canada.
Department of Surgery, Laval University, Québec City, Québec, G1V 0A6, Canada.
Obes Surg. 2023 Apr;33(4):1092-1098. doi: 10.1007/s11695-023-06455-z. Epub 2023 Jan 28.
Like most Western armies, obesity affects Canadian Armed Forces (CAF) personnel. Bariatric surgery is an effective treatment for obesity. However, this is not yet accepted for active-duty soldiers in most countries. The CAF have approved bariatric surgery since 2005. Our aim is to assess weight loss, resolution of obesity-related comorbidities, and impacts of bariatric surgery on military careers.
We retrospectively reviewed the perioperative data, long-term bariatric results, and military outcomes of 108 CAF active-duty military personnel who underwent bariatric surgery in Canada over a 61-month period.
The cohort was predominantly male (66.7%) with a mean preoperative body mass index (BMI) of 43.6 ± 5.8 kg/m. Roux-Y gastric bypass was performed in 59 patients, sleeve gastrectomy in 29, and gastric banding in 20. All the surgeries were performed laparoscopically. The total body weight loss at the last follow-up visit was 22.5 ± 11.0%. Remission or improvement of hypertension was observed in 91.2%, diabetes in 85.7%, gastroesophageal reflux disorder (GERD) in 43.6%, sleep apnea in 43.1%, and dyslipidemia in 42.9%. One patient (0.9%) was medically released due to postoperative complications. Fifteen patients (13.9%) were deployed postoperatively. The combined deployable and possibly deployable statuses increased from 35.4% preoperatively to 47.9% postoperatively.
This is the largest series of bariatric surgeries performed in active-duty military personnel. Bariatric surgery is effective and safe and improves deployability without impairing military careers. These results are relevant to the military of many industrialized countries. Bariatric surgery should be considered for all active-duty military personnel who meet surgical criteria for the treatment of obesity.
与大多数西方国家军队一样，肥胖问题也影响着加拿大武装部队（CAF）人员。减重手术是肥胖症的有效治疗方法。然而，在大多数国家，现役士兵尚未接受这种治疗。自 2005 年以来，加拿大武装部队已批准进行减重手术。我们的目的是评估减重手术对体重减轻、肥胖相关合并症的解决以及对军事生涯的影响。
我们回顾性分析了在加拿大进行减重手术的 108 名现役加拿大武装部队人员的围手术期数据、长期减重结果和军事结果，随访时间为 61 个月。
该队列主要由男性（66.7%）组成，平均术前体重指数（BMI）为 43.6±5.8kg/m²。59 例患者接受了 Roux-en-Y 胃旁路术，29 例接受了袖状胃切除术，20 例接受了胃束带术。所有手术均通过腹腔镜完成。最后一次随访时的总体体重减轻为 22.5±11.0%。91.2%的患者高血压得到缓解或改善，85.7%的患者糖尿病得到缓解或改善，43.6%的患者胃食管反流病（GERD）得到缓解，43.1%的患者睡眠呼吸暂停得到缓解，42.9%的患者血脂异常得到缓解。1 例（0.9%）患者因术后并发症而被医学放行。15 例（13.9%）患者术后部署。手术前后可部署和可能部署的总人数从术前的 35.4%增加到 47.9%。
这是现役军人中进行的最大系列减重手术。减重手术有效且安全，可提高可部署性，而不会损害军事生涯。这些结果与许多工业化国家的军队相关。对于符合肥胖治疗手术标准的所有现役军人，都应考虑进行减重手术。
