Crozet J, Pasquer A, Pelascini E, Robert M
Department of digestive surgery, center of bariatric surgery, university hospital of Édouard-Herriot, hospices civils de Lyon, Lyon, France; Specialized center of obesity, university hospital of Lyon, hospices civils de Lyon, Pierre-Bénite, France; University Claude Bernard Lyon 1, Lyon, France.
Department of digestive surgery, center of bariatric surgery, university hospital of Édouard-Herriot, hospices civils de Lyon, Lyon, France; Specialized center of obesity, university hospital of Lyon, hospices civils de Lyon, Pierre-Bénite, France; University Claude Bernard Lyon 1, Lyon, France.
J Visc Surg. 2023 Apr;160(2S):S7-S11. doi: 10.1016/j.jviscsurg.2022.12.001. Epub 2023 Mar 13.
The outcomes of bariatric surgery, while often impressive, are not universally satisfactory; they vary from patient to patient and from operation to operation. Between 20-30% of patients experience suboptimal weight loss or substantial weight regain early in their postoperative course. Confronted with this chronic disease, and given that failures are difficult to manage, it is essential to better characterize obesity preoperatively, considering other metrics beyond just the body mass index (BMI), to select the best candidates for surgery and optimize the benefit/risk ratio. Based on the data of the most recent studies on bariatric surgery, our objective is to identify the predictive factors of weight loss as well as the risk factors of failure. Our analysis indicates that the choice of the surgical technique, age, initial BMI, ethnic origin, the presence of eating disorders and metabolic factors all have an impact on weight-loss outcomes after bariatric surgery. Thus, it is of major importance to carefully select patients during a preoperative multidisciplinary discussion in order to optimize weight loss and metabolic outcomes.
减肥手术的效果虽然常常令人印象深刻,但并非普遍令人满意;其效果因患者个体以及手术方式的不同而有所差异。20%至30%的患者在术后早期体重减轻不理想或体重大幅反弹。面对这种慢性病,鉴于治疗失败难以处理,术前更好地对肥胖进行特征描述至关重要,要考虑除体重指数(BMI)之外的其他指标,以挑选出最适合手术的患者并优化获益/风险比。基于近期减肥手术研究的数据,我们的目标是确定体重减轻的预测因素以及手术失败的风险因素。我们的分析表明,手术技术的选择、年龄、初始BMI、种族、饮食失调的存在以及代谢因素都会对减肥手术后的体重减轻结果产生影响。因此,在术前多学科讨论中仔细挑选患者以优化体重减轻和代谢结果至关重要。