代谢和减肥手术:手术选择和结果
J Lubbe1, J G M Smit2, M Z Koto3
1Division of Surgery, Department of Surgical Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
|December 11, 2025
概括
代谢和减肥手术 (MBS) 建议用于BMI超过35kg/m2的个体,以减少死亡率,更好地减肥,并缓解与肥胖有关的疾病. 对于那些有代谢疾病和BMI为30-34.9 kg/m2.9的人来说,还应该考虑MBS.
科学领域:
- 肥胖医学 肥胖医学
- 外科胃肠道外科手术
- 公共卫生 公共卫生
背景情况:
- 肥胖是一种复杂的慢性疾病,需要有效的长期管理策略.
- 代谢和减肥手术 (MBS) 已成为管理严重肥胖及其相关并发症的强大工具.
- 目前的指南需要更新,以反映MBS有效性和安全性的最新证据.
研究的目的:
- 为适当使用代谢和减肥手术 (MBS) 提供基于证据的建议.
- 为了指导临床医生选择最有效的外科手术程序,对于患有肥胖和代谢疾病的个人.
- 在死亡率,体重减轻,疾病缓解和生活质量方面概述MBS的好处.
主要方法:
- 对代谢和腹部外科手术现有的文献进行系统审查和元分析.
- 根据证据水平和研究质量对证据和建议进行分级.
- 在肥胖管理领域的多学科专家之间建立共识.
主要成果:
- 对于BMI>35kg/m2的个体,不论伴随性疾病,MBS建议用于降低死亡率,降低体重,以及缓解2型糖尿病 (T2DM),血脂不良,高血压和代谢相关性肝病 (MASLD).
- 对于具有代谢疾病和BMI为30-34.9 kg/m2的个体,应考虑MBS.
- 与Roux-en-Y胃绕道相比,由于并发症和长期失败,不建议使用可调节的胃带和一次解肠胃绕道.
结论:
- 代谢和减肥手术是严重肥胖和相关代谢疾病的高效治疗方法.
- 患者特定的需求和多学科团队 (MDT) 的投入对于选择最佳的减肥手术至关重要.
- 需要继续进行研究,以进一步完善MBS的指示和技术.
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