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[肥胖患者何时应转诊至内分泌科?减重手术的当前指征]

[When should a patient with obesity be referred to endocrinology? Current indications for bariatric surgery].

作者信息

Rius Acebes Laura, Sánchez-Pacheco-Tardon Myriam, Orozco Beltrán Domingo

机构信息

Servicio de Cirugía, Hospital Universitario San Juan de Alicante, Alicante, España.

Servicio de Endocrinología y Nutrición, Hospital General Universitario Dr. Balmis, Alicante, España.

出版信息

Aten Primaria. 2024 Jul;56(7):102961. doi: 10.1016/j.aprim.2024.102961. Epub 2024 May 18.

Abstract

Bariatric surgery (BS) has been shown to be effective and efficient, but only 1% of selected patients will ever receive it. Compared to medical treatment of obesity, BS has demonstrated greater long-term sustained weight loss, a reduction in both total and cardiovascular (CV) mortality, improvement or remission of CV risk factors and other comorbidities associated with obesity, as well as improved mobility and quality of life. BS presents similar risks to other abdominal surgeries, with obesity as an added risk factor. However, mortality after this type of surgery is less than 1%, being in specialised centres even lower than 0.3%, with a morbidity of less than 7%. The most commonly performed surgical procedures at present are vertical gastrectomy and Roux---Y gastric bypass, preferably by laparoscopic approach.

摘要

减肥手术已被证明是有效且高效的,但只有1%的选定患者会接受该手术。与肥胖症的药物治疗相比,减肥手术已显示出更显著的长期持续体重减轻、总死亡率和心血管(CV)死亡率降低、CV危险因素及与肥胖相关的其他合并症得到改善或缓解,以及改善了活动能力和生活质量。减肥手术与其他腹部手术存在相似的风险,肥胖是一个额外的风险因素。然而,这类手术的死亡率低于1%,在专业中心甚至低于0.3%,发病率低于7%。目前最常实施的外科手术是垂直胃切除术和Roux - Y胃旁路术,最好采用腹腔镜手术方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d0a/11126878/bb026b095a7d/gr1.jpg

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