¿Cuándo derivar a endocrinología el paciente con obesidad? Indicaciones actuales de la cirugía bariátrica

IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Atencion Primaria Pub Date : 2024-05-18 DOI:10.1016/j.aprim.2024.102961
Laura Rius Acebes , Myriam Sánchez-Pacheco-Tardon , Domingo Orozco Beltrán
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Abstract

Bariatric surgery (BS) has been shown to be effective and efficient, but only 1% of selected patients will ever receive it.

Compared to medical treatment of obesity, BS has demonstrated greater long-term sustained weight loss, a reduction in both total and cardiovascular (CV) mortality, improvement or remission of CV risk factors and other comorbidities associated with obesity, as well as improved mobility and quality of life.

BS presents similar risks to other abdominal surgeries, with obesity as an added risk factor. However, mortality after this type of surgery is less than 1%, being in specialised centres even lower than 0.3%, with a morbidity of less than 7%.

The most commonly performed surgical procedures at present are vertical gastrectomy and Roux---Y gastric bypass, preferably by laparoscopic approach.

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[肥胖症患者何时应转诊至内分泌科?减肥手术的当前适应症]。
减肥手术(BS)已被证明是有效和高效的,但只有 1%的选定患者会接受这种手术。与肥胖症的药物治疗相比,减重手术的长期持续减重效果更佳,总死亡率和心血管(CV)死亡率均有所降低,心血管风险因素和其他与肥胖症相关的并发症得到改善或缓解,活动能力和生活质量也有所提高。腹腔镜手术的风险与其他腹部手术类似,肥胖是一个额外的风险因素。不过,这类手术的死亡率低于 1%,在专业中心甚至低于 0.3%,发病率低于 7%。目前最常用的手术方法是垂直胃切除术和Roux--Y胃旁路术,最好采用腹腔镜方法。
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来源期刊
Atencion Primaria
Atencion Primaria 医学-医学:内科
CiteScore
2.90
自引率
8.00%
发文量
156
审稿时长
33 days
期刊介绍: Atención Primaria es una revista que publica trabajos de investigación relativos al ámbito de la atención primaria de salud. Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a la promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada para recoger y difundir la producción científica realizada desde los centros de atención primaria de salud sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria, entre otros.
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