Xiao He, Du Yudie, Tan Yuanyuan, Ren Yixing
Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Institute of Hepatobiliary Pancreatic Intestinal Diseases, North Sichuan Medical College, Nanchong, China.
Front Nutr. 2024 Dec 23;11:1510403. doi: 10.3389/fnut.2024.1510403. eCollection 2024.
Bariatric surgery stands as the most potent treatment for achieving substantial weight reduction and alleviating the complications associated with obesity. However, it is not the treatment of choice for patients with obesity combined with type 2 diabetes mellitus, and the benefit of bariatric surgery varies widely among individuals. There is a noticeable inconsistency in the outcomes following these procedures. The ability to predict how an individual will respond to bariatric surgery is a valuable asset in clinical practice. And the importance of postoperative interventions should not be underestimated. Proactive measures targeting both pre- and post-operative eating habits and lifestyle adjustments are of greater significance than the investigation into pre-operative factors alone. The judicious application of medication, endoscopic intervention and conversional surgeries after bariatric surgery can yield superior outcomes in managing recurrent weight regain and the recurrence of diabetes, albeit with consideration for the associated complication rates.
减肥手术是实现大幅减重和缓解肥胖相关并发症的最有效治疗方法。然而，它并非肥胖合并2型糖尿病患者的首选治疗方法，减肥手术的益处因个体差异很大。这些手术的结果存在明显的不一致性。预测个体对减肥手术反应的能力在临床实践中是一项宝贵的资产。术后干预的重要性不应被低估。针对术前和术后饮食习惯及生活方式调整的积极措施比仅调查术前因素更为重要。减肥手术后合理应用药物、内镜干预和转换手术在管理体重反弹复发和糖尿病复发方面可产生更好的效果，尽管要考虑相关的并发症发生率。
