Bariatric Surgery for Morbid Obesity: Pre-operative Assessment, Surgical Techniques and Post-operative Monitoring
Bariatric Surgery for Morbid Obesity: Pre-operative Assessment, Surgical Techniques and Post-operative Monitoring
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DOI：
10.1177/147323000903700543
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发表时间：
2009-09-01
影响因子：
1.6
通讯作者：
Dinevski, D.
中科院分区：
文献类型：
--
作者：
Breznikar, B.;Dinevski, D.
该观察性临床分析包括246例在2005年5月至2008年12月期间接受可调节胃束带术（AGB）、腹腔镜袖状胃切除术（LSG）或胃旁路术（GBP）的患者。最常见的外科手术是AGB（73.2%的患者）。对患者进行全面的心理评估，并提供术前和术后心理和饮食支持。共111/120（92.5%）AGB患者，21/30 LSG患者占70.0%，（22.2%）GBP患者已被监测至少1年，其平均体重减轻（超额失重率）分别为24.7 kg（52.4%）、46.0 kg（57.9%）和40.5 kg（77.9%）。AGB手术的并发症最少，但并不适合所有患者。良好的术前心理评估已被证明是必要的成功的结果，在超级肥胖，我们更喜欢使用LSG。外科医生应该学习进行腹腔镜Roux-en-Y GBP所需的技能，因为它很可能成为肥胖手术治疗的标准护理。减肥手术后的最佳结果是通过多学科方法实现的，包括参与由心理学家指导的支持小组。
This observational clinical analysis included 246 patients who underwent surgery for adjustable gastric banding (AGB), laparoscopic sleeve gastrectomy (LSG), or gastric bypass (GBP) between May 2005 and December 2008. The most frequent surgical procedure was for AGB (73.2% of patients). A thorough psychological evaluation of the patients was carried out, and pre- and post-operative psychological and dietary support was offered. A total of 111/120 (92.5%) AGB patients, 21/30 (70.0%) LSG patients and 8/36 (22.2%) GBP patients have been monitored for at least 1 year, and their mean weight losses (percentage excess weight loss) were 24.7 kg (52.4%), 46.0 kg (57.9%) and 40.5 kg (77.9%), respectively. The AGB procedure was associated with the fewest complications but is not appropriate for all patients. Good pre-operative psychological evaluation has been shown to be necessary for successful outcomes and, in the super-obese, we prefer to use LSG. Surgeons should learn the skills needed to perform laparoscopic Roux-en-Y GBP as it is likely to become the standard-of-care for the surgical treatment of obesity The best outcomes following bariatric surgery are achieved with a multidisciplinary approach, including participation in a support group guided by a psychologist.