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Bariatric Surgery - From the Non-surgical Approach to the Post-surgery Individual Care [Working Title]最新文献

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Weight Regain and Insufficient Weight Loss after Bariatric Surgery: A Call for Action 减肥手术后体重恢复和减重不足:行动呼吁
Wahiba Elhag, W. Ansari
Despite successful weight loss after bariatric surgery (BS), weight regain (WR) may occur on long term following most bariatric procedures, with 20–30% of patients either failing to reach their target weight goals or failing to maintain the achieved weight loss. Significant WR has important health consequences, including the reversal of the improved obesity-related comorbidities and psychological function leading to decreased quality of life. Given the challenges faced by these patients, there is a need for multidisciplinary approaches to deal with WR. This chapter addresses the issue of WR among bariatric patients. It starts with the various definitions of insufficient weight loss and WR and the prevalence of weight regain by type of bariatric procedure. The chapter then explores the underlying causes as well as the predictors of WR. It will also outline the behavioral and psychotherapeutic, dietary and exercise strategies employed in the prevention of post-surgery WR. The chapter will then highlight the non-surgical and surgical approaches used in the management of WR. The chapter will conclude with a summary of the findings emphasizing that WR is complex and multifactorial, requiring multidisciplinary and multimodal dietary, behavioral, pharmacological, and surgical management strategies tailored to meet the individual needs of each patient.
尽管减肥手术(BS)后体重减轻成功,但大多数减肥手术后长期体重反弹(WR)可能会发生,20-30%的患者要么无法达到目标体重目标,要么无法维持已达到的体重减轻。显著的WR具有重要的健康后果,包括逆转肥胖相关合并症的改善和导致生活质量下降的心理功能。鉴于这些患者面临的挑战,有必要采用多学科方法来处理WR。本章讨论肥胖患者的WR问题。本文首先介绍了减肥不足和WR的各种定义,以及不同类型减肥手术中体重反弹的流行情况。然后,本章探讨了WR的潜在原因以及预测因素。它还将概述用于预防术后WR的行为和心理治疗、饮食和运动策略。本章将重点介绍在WR治疗中使用的非手术和手术方法。本章将总结研究结果,强调WR是复杂和多因素的,需要多学科和多模式的饮食、行为、药理学和手术管理策略,以满足每个患者的个性化需求。
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引用次数: 6
Laparoscopic Sleeve Gastrectomy: Outcomes, Safety and Complications 腹腔镜袖式胃切除术:结果、安全性和并发症
Wahiba Elhag, W. Ansari
Worldwide, the numbers of laparoscopic sleeve gastrectomy (LSG) performed grown exponentially over the last decade, because of its simplicity, safety profile and excellent outcomes in terms of durable weight loss and improvement of obesity-associated comorbidities. This chapter will provide a comprehensive review on the outcomes of LSG as a metabolic surgery. It appraises LSG's short, mid and long term weight loss outcomes, and compares these outcomes with those of other types of bariatric surgery. Then, a wider range of LSG outcomes are discussed, including a variety of comorbidities, clinical, biochemical and inflammatory parameters, while appraising the positive metabolic effects of LSG. The chapter also outlines the issues pertaining to LSG among a range of special populations such as adolescents, the elderly, renal transplant patients and others. The chapter concludes with a review of the safety and most common complications that may be encountered in the short term and long term, including surgical and nutritional complications, as well as mortality.
在世界范围内,腹腔镜袖式胃切除术(LSG)的数量在过去十年中呈指数级增长,因为它简单、安全、持久减肥和改善肥胖相关合并症方面的良好效果。本章将对LSG作为一种代谢手术的结果进行全面的综述。它评估了LSG的短期、中期和长期减肥结果,并将这些结果与其他类型的减肥手术的结果进行了比较。然后,讨论更广泛的LSG结果,包括各种合并症,临床,生化和炎症参数,同时评估LSG的积极代谢作用。本章还概述了在青少年、老年人、肾移植患者等一系列特殊人群中与LSG有关的问题。本章最后回顾了短期和长期可能遇到的安全性和最常见的并发症,包括手术和营养并发症以及死亡率。
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引用次数: 4
From Prehab to Rehab: The Functional Restoration of a Bariatric Individual 从减肥到康复:一个肥胖个体的功能恢复
A. Suhaimi, B. Yuliawiratman
The bariatric population presents at a greater risk for functional decline with increasing weight and advancing age. This can be prevented at various time points through multidisciplinary rehabilitation interventions in a multitude of different settings to accommodate the severity of an individuals’ disability and to target different functional goals. Bariatric rehabilitation is a multipronged approach that addresses the ongoing functional impairment, medical comorbidities, hospital-related deconditioning and prevents future cardiovascular and musculoskeletal complications from progressing. The emerging concept of utilising rehabilitation interventions and goal-centric approach as means to reduce post-operative complications and enhance surgical outcomes is also discussed. Pragmatic approaches to post-surgical bariatric rehabilitation are discussed highlighting the multi-faceted rehabilitation concerns to achieve optimal functionality in the face of a chronic medical condition.
随着体重的增加和年龄的增长,肥胖人群出现功能衰退的风险更大。这可以在不同的时间点通过多种不同环境的多学科康复干预来预防,以适应个人残疾的严重程度并针对不同的功能目标。减肥康复是一种多管齐下的方法,可解决正在发生的功能损害、医疗合并症、医院相关的条件降低,并防止未来心血管和肌肉骨骼并发症的进展。本文还讨论了利用康复干预和以目标为中心的方法作为减少术后并发症和提高手术效果的手段的新兴概念。讨论了手术后减肥康复的实用方法,强调了在面对慢性疾病时实现最佳功能的多方面康复问题。
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引用次数: 1
Psychological Considerations for Bariatric Surgery 减肥手术的心理考虑
Anna Guerrini Usubini, R. Cattivelli, V. Villa, Giorgia Varallo, Valentina Granese, G. Pietrabissa, G. Manzoni, G. Castelnuovo, E. Molinari
Obesity management requires a multidisciplinary, integrated treatment composed of medical, nutritional, physical, and psychological interventions. Currently, bariatric surgery is the most suitable treatment available in case of severe obesity, or obesity with comorbid medical conditions. Despite bariatric surgery results in a significant weight loss in most of the cases, a not-inconsiderable portion of patients does not achieve relevant outcomes, in terms of limited weight loss or weight regain due to psychological problems. The pre-operative evaluation of the psychological conditions of the candidates for bariatric interventions and pre/post-surgical psychological support is required in order to achieve the desired post-operative outcomes for a long time. In this chapter, we will elucidate the core components of the psychological assessment of bariatric candidates. Moreover, the main directions for the pre/post-surgery psychological support will be provided.
肥胖管理需要多学科的综合治疗,包括医学、营养、身体和心理干预。目前,减肥手术是最适合的治疗严重肥胖,或肥胖与合并症的医疗条件。尽管在大多数情况下,减肥手术都能显著减轻体重,但也有相当一部分患者由于心理问题,体重减轻或体重反弹有限,没有达到相关结果。为了长期达到预期的术后效果,需要对减肥干预患者的术前心理状况进行评估和术前/术后心理支持。在本章中,我们将阐明肥胖候选人心理评估的核心组成部分。并提供术前/术后心理支持的主要方向。
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引用次数: 4
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Bariatric Surgery - From the Non-surgical Approach to the Post-surgery Individual Care [Working Title]
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