Parzer Verena, Resl Michael, Stechemesser Lars, Wakolbinger Maria, Itariu Bianca, Brix Johanna Maria
1. Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich.
Karl Landsteiner Institut für Adipositas und Stoffwechselerkrankungen, Klinik Landstraße, Wien, Österreich.
Wien Klin Wochenschr. 2023 Nov;135(Suppl 6):729-742. doi: 10.1007/s00508-023-02272-7. Epub 2023 Oct 11.
Bariatric surgery results in significant weight loss, reduction or even remission of obesity-associated comorbidities, reduced mortality, and improved quality of life in many patients; however, obesity is a chronic disease, thus follow-up care is required after bariatric surgery. Furthermore, specific issues, such as micronutrient deficiencies and subsequent complications, can arise both in the short-term and the long-term. Abdominal pain after bariatric surgery must always be regarded as a serious symptom. A further focus should be on the diagnosis and treatment of dumping syndrome. Patients with type 2 diabetes should be regularly screened for recurrent hyperglycemia as well as specific sequelae, even though blood glucose levels may be substantially improved or normalized. In addition to centers with multidisciplinary teams, primary care and, in particular, general practitioners will play an increasingly more important role in the follow-up care after bariatric surgery.
减肥手术可使许多患者显著减重,肥胖相关合并症减轻甚至缓解,死亡率降低,生活质量提高;然而,肥胖是一种慢性病,因此减肥手术后需要进行随访护理。此外,短期和长期都可能出现特定问题,如微量营养素缺乏及随后的并发症。减肥手术后的腹痛必须始终被视为严重症状。另一个重点应是倾倒综合征的诊断和治疗。2型糖尿病患者应定期筛查复发性高血糖以及特定后遗症,尽管血糖水平可能已大幅改善或恢复正常。除了拥有多学科团队的中心外,初级保健,尤其是全科医生在减肥手术后的随访护理中将发挥越来越重要的作用。