减肥手术后的倾倒综合征:患病率、病理生理学和在减肥中的作用——一项系统综述。

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2023-07-01 DOI:10.51821/86.3.11476
A D'hoedt, T Vanuytsel
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引用次数: 0

摘要

背景:倾倒综合征是减肥手术后常见且众所周知的不良事件,涵盖了早期和晚期倾倒的动态范围。胃排空加速通常被认为是胃肠道和血管舒缩性疾病的原因。然而,倾倒的确切病理生理学还有很多不确定性。据推测,该综合征是减肥手术的理想结果,有助于更有效地减肥,但支持数据很少。方法:于2021年7-8月在PubMed进行系统检索。分析了最常见的减肥手术后倾倒的发生率,以及潜在的病理生理学及其在减肥中的作用。结果:Roux-en-Y胃分流术(RYGB)与术后倾倒发生率最高有关。快速转运诱导神经体液变化,导致餐后血糖和胰岛素水平失衡,导致低血糖,这是晚倾倒的标志。如果以积极的方式接受,早期倾倒可以成为保持严格饮食模式的工具,但与减肥程度没有显著关系。然而,延迟倾倒是有害的,并促进整体更高的热量摄入。结论:Dumping综合征常见于减肥手术后,尤其是RYGB手术后。病理生理学是复杂和模糊的。目前可用的数据不支持倾倒作为减肥手术后诱导体重减轻的必要条件。
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Dumping syndrome after bariatric surgery: prevalence, pathophysiology and role in weight reduction - a systematic review.

Background: Dumping syndrome is a frequent and wellknown adverse event after bariatric surgery and covers a dynamic spectrum of early and late dumping. Accelerated gastric emptying is generally considered to be the cause of gastrointestinal and vasomotor complaints. However, there is much uncertainty regarding the exact pathophysiology of dumping. It has been speculated that the syndrome is a desired consequence of bariatric surgery and contributes to more efficient weight loss, but supporting data are scarce.

Methods: A systematic search was conducted in PubMed in July-August 2021. The prevalence of dumping after the most frequently performed bariatric procedures was analyzed, as well as underlying pathophysiology and its role in weight reduction.

Results: Roux-en-Y gastric bypass (RYGB) is associated with the highest postoperative prevalence of dumping. The fast transit induces neurohumoral changes which contribute to an imbalance between postprandial glucose and insulin levels, resulting in hypoglycemia which is the hallmark of late dumping. Early dumping can, when received in a positive way, become a tool to maintain a strict dietary pattern, but no significant relationship to the degree of weight loss has been shown. However, late dumping is detrimental and promotes overall higher caloric intake.

Conclusion: Dumping syndrome is common after bariatric surgery, especially after RYGB. The pathophysiology is complex and ambiguous. Currently available data do not support dumping as a necessary condition to induce weight loss after bariatric surgery.

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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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