Metabolic Syndrome after Bariatric Surgery. Results Depending on the Technique Performed
Metabolic Syndrome after Bariatric Surgery. Results Depending on the Technique Performed
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DOI：
10.1007/s11695-010-0309-6
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发表时间：
2011-02-01
期刊：
影响因子：
2.9
通讯作者：
Martinez, M.
中科院分区：
文献类型：
--
作者：
Antonio Gracia-Solanas, Jose;Elia, M.;Martinez, M.
减肥手术后代谢综合征缺乏长期研究。我们的目的是显示减肥手术后代谢综合征的定义参数的演变，长达10年的随访，以澄清什么技术可以获得更好的结果，并发症更少。125例病态肥胖和超肥胖患者接受了垂直带状胃成形术。265例病态肥胖和超肥胖患者行胆胰分流术（Scopinaro和改良胆胰分流术），152例病态肥胖患者行腹腔镜胃旁路术。所有组的平均随访时间长达7年，术前Scopinaro组114例（76%）、改良胆胰分流术组85例（73.9%）、腹腔镜胃旁路术组81例（53.4%）和垂直束带胃成形术组98例（78.4%）诊断为代谢综合征。当代谢综合征的参数进行了评估，在7年的后续行动，由于体重增加，这些结果改变附近的术前值在腹腔镜胃旁路术和垂直带状gastroplasty.According组，根据我们的研究结果，解决代谢综合征的最佳技术是改良胆胰分流术。由于其发病率高，只有在超肥胖患者中才必须考虑。在肥胖患者中，腹腔镜胃旁路术可能是一个不太激进的选择，但它应该与生活方式的改变相结合，以避免长期体重增加。只有在少数经过精心挑选的情况下，才可能需要采取限制性程序。
There is a lack of long-term studies for metabolic syndrome after bariatric surgery. Our aim is to show the evolution of the parameters that define the metabolic syndrome after bariatric surgery, up to 10 years of follow-up, in order to clarify what technique gets better results with fewer complications.The IDF definition of the metabolic syndrome was used for this study. One hundred twenty-five morbid obese and superobese patients underwent vertical banded gastroplasty. Two hundred sixty-five morbid obese and superobese patients had biliopancreatic diversion (Scopinaro and modified biliopancreatic diversions), and 152 morbid obese patients underwent laparoscopic gastric bypass. A mean follow-up of up to 7 years was done in all groups.Prior to surgery, metabolic syndrome was diagnosed in 114 patients of Scopinaro group (76%), in 85 patients of modified biliopancreatic diversion group (73.9%), in 81 patients of laparoscopic gastric bypass (53.4%), and in 98 patients of vertical banded gastroplasty (78.4%). When metabolic syndrome parameters were evaluated at 7 years of follow-up, owing to weight gain, these results changed nearby to preoperative values in both laparoscopic gastric bypass and vertical banded gastroplasty groups.According to our results, the best technique to resolve metabolic syndrome is the modified biliopancreatic diversion. Due to its high morbidity, it only must be considered in superobese patients. In obese patients, the laparoscopic gastric bypass may be a less agressive choice, but it should be coupled with lifestyle changes to keep away from the weight gain in the long run. Restrictive procedures may be indicated only in a few well-selected cases.