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修订代谢与减重手术的挑战:解开减重手术修订复杂性及解决方案的综合指南

Challenges of Revisional Metabolic and Bariatric Surgery: A Comprehensive Guide to Unraveling the Complexities and Solutions of Revisional Bariatric Procedures.

作者信息

Evans Lorna A, Castillo-Larios Rocio, Cornejo Jorge, Elli Enrique F

机构信息

Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Rd., Jacksonville, FL 32224, USA.

出版信息

J Clin Med. 2024 May 25;13(11):3104. doi: 10.3390/jcm13113104.

DOI:10.3390/jcm13113104
PMID:38892813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11172990/
Abstract

Revisional metabolic and bariatric surgery (RMBS) presents unique challenges in addressing weight loss failure or complications arising from initial bariatric procedures. This review aims to explore the complexities and solutions associated with revisional bariatric procedures comprehensively, offering insights into the evolving terrain of metabolic and bariatric surgery. A literature review is conducted to identify pertinent studies and expert opinions regarding RMBS. Methodological approaches, patient selection criteria, surgical techniques, preoperative assessments, and postoperative management strategies are synthesized to provide a comprehensive overview of current practices and advancements in the field, including institutional protocols. This review synthesizes key findings regarding the challenges encountered in RMBS, including the underlying causes of primary procedure failure, anatomical complexities, technical considerations, and assessments of surgical outcomes. Additionally, patient outcomes, complication rates, and long-term success are presented, along with institutional approaches to patient assessment and procedure selection. This review provides valuable insights for clinicians grappling with the complexities of RMBS. A comprehensive understanding of patient selection, surgical techniques, preoperative management, and postoperative care is crucial for enhancing outcomes and ensuring patient satisfaction in the field of metabolic bariatric surgery.

摘要

修正性代谢和减肥手术(RMBS)在解决减肥失败或初次减肥手术引起的并发症方面面临独特挑战。本综述旨在全面探讨与修正性减肥手术相关的复杂性和解决方案,深入了解代谢和减肥手术不断变化的领域。进行文献综述以确定有关RMBS的相关研究和专家意见。综合方法学方法、患者选择标准、手术技术、术前评估和术后管理策略,以全面概述该领域的当前实践和进展,包括机构方案。本综述综合了关于RMBS中遇到的挑战的关键发现,包括初次手术失败的根本原因、解剖复杂性、技术考虑因素以及手术结果评估。此外,还介绍了患者结局、并发症发生率和长期成功率,以及机构对患者评估和手术选择的方法。本综述为应对RMBS复杂性的临床医生提供了有价值的见解。全面了解患者选择、手术技术、术前管理和术后护理对于提高代谢减肥手术领域的疗效和确保患者满意度至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c048/11172990/3894ee78ea0f/jcm-13-03104-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c048/11172990/3894ee78ea0f/jcm-13-03104-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c048/11172990/3894ee78ea0f/jcm-13-03104-g001.jpg

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本文引用的文献

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IFSO Worldwide Survey 2020-2021: Current Trends for Bariatric and Metabolic Procedures.2020-2021 年 IFSO 全球调查:减重与代谢手术的当前趋势。
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Minimally Invasive Gastrointestinal Surgery: A Review.微创胃肠手术:综述
Cureus. 2023 Nov 15;15(11):e48864. doi: 10.7759/cureus.48864. eCollection 2023 Nov.
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Life (Basel). 2023 Sep 13;13(9):1905. doi: 10.3390/life13091905.
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Long-term Follow-up 15 Years After Duodenal Switch or Gastric Bypass for Super Obesity: a Randomized Controlled Trial.超级肥胖患者行十二指肠转流术或胃旁路术 15 年后的长期随访:一项随机对照试验。
Obes Surg. 2023 Oct;33(10):2981-2990. doi: 10.1007/s11695-023-06767-0. Epub 2023 Aug 16.
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