Flancbaum L, Choban P S
Department of Surgery, Ohio State University College of Medicine, Columbus 43210, USA.
Annu Rev Med. 1998;49:215-34. doi: 10.1146/annurev.med.49.1.215.
Obesity is perhaps the most significant public health problem facing the United States today. Obese patients are at increased risk for numerous medical problems, which can adversely affect surgical outcome. However, these risks have not uniformly translated into increased or prohibitive operative morbidity and mortality in this population. With appropriate perioperative precautions and monitoring, the incidence of serious cardiovascular and pulmonary complications can be minimized. Obese patients can be treated as safely and effectively as their normal weight counterparts under most circumstances and should not be denied surgical treatment for any disorder when surgery constitutes the most appropriate therapy. When indicated, surgical treatment should be considered for patients with clinically severe obesity, since currently it appears to offer the best long-term results for weight control and amelioration of comorbidity.
肥胖或许是当今美国面临的最为重要的公共卫生问题。肥胖患者出现众多医疗问题的风险增加，这些问题会对手术结果产生不利影响。然而，这些风险并未一致地转化为该人群手术发病率和死亡率的增加或过高。通过适当的围手术期预防措施和监测，严重心血管和肺部并发症的发生率可降至最低。在大多数情况下，肥胖患者可以与体重正常的患者一样安全有效地接受治疗，并且当手术是最合适的治疗方法时，不应因任何疾病而拒绝为肥胖患者进行手术治疗。当有指征时，对于临床严重肥胖的患者应考虑手术治疗，因为目前手术似乎为体重控制和合并症改善提供了最佳的长期效果。
