Obesity and bariatrics for the endoscopist: new techniques.
Obesity and bariatrics for the endoscopist: new techniques.
复制标题
DOI：
10.1177/1756283x11398737
复制
发表时间：
2011-11-01
影响因子：
4.2
通讯作者：
Thompson, Christopher C
中科院分区：
文献类型：
--
作者：
Abu Dayyeh, Barham K;Thompson, Christopher C
肥胖及其相关疾病，包括 2 型糖尿病和心血管疾病，已达到流行病的程度。胃肠减肥手术（GIWLS）在实现显着且持续的减肥和糖尿病解决方面显示出最大的希望。然而，肥胖流行的严重程度与导致人群肥胖分布发生显着变化而进行的外科手术数量之间存在很大的不匹配。这种不匹配的原因是高昂的手术费用、与手术干预相关的发病率和死亡率，以及肥胖带来的最大公共卫生负担来自于轻度至中度肥胖人群体重指数分布中心周围的人群，而不是 GIWLS 所针对的重度肥胖分布尾部的人群。新的内窥镜方法利用我们对 GIWLS 工作生理机制的理解不断进步，正在开发中，为减肥手术并发症的治疗和肥胖的初级治疗提供可行的替代方案。这些方法可能具有减少侵入性、可逆性、成本效益以及适用于更大一部分中度肥胖人群的额外优势。
Obesity and its associated conditions, including type 2 diabetes and cardiovascular disease, have reached epidemic proportions. Gastrointestinal weight loss surgery (GIWLS) shows the most promise in achieving significant and sustained weight loss and diabetes resolution. However, a large mismatch exists between the magnitude of the obesity epidemic and the number of surgical procedures performed to produce a significant shift in the distribution of obesity on a population level. This mismatch is fueled by high surgical costs, morbidity and mortality associated with surgical interventions, and the fact that the greatest public health burden of obesity comes from those around the center of the population body mass index distribution with mild to moderate obesity, rather than those at the distribution tail with severe obesity that GIWLS targets. New endoscopic methods, capitalizing on advances in our understanding of the physiological mechanisms by which GIWLS works, are developing to provide viable alternatives in the treatment of bariatric surgical complications, and for the primary treatment of obesity. These methods may have the added advantage of reduced invasiveness, reversibility, cost-effectiveness, and applicability to a larger segment of the population with moderate obesity.