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成人病态肥胖症的减肥手术治疗。

Bariatric surgery for treatment of morbid obesity in adults.

作者信息

Park Ki Bum, Jun Kyong-Hwa

机构信息

Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Clinic of Metabolic and Bariatric Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Korean J Intern Med. 2025 Jan;40(1):24-39. doi: 10.3904/kjim.2024.219. Epub 2025 Jan 1.

Abstract

Morbid obesity requires active intervention, with treatment options including lifestyle modification, pharmacotherapy, and surgery. As the prevalence of obesity continues to rise in Korea, it is crucial for specialists and general practitioners to have a comprehensive understanding of obesity and its management. Bariatric surgery is the most effective treatment modality for obesity, leading to significant weight loss and metabolic benefits. It involves surgical alterations of normal anatomical structures to improve overall health. Therefore, selecting the appropriate procedure based on the individual characteristics of patients is crucial. This review highlights the two most commonly performed bariatric procedures worldwide, including in Korea: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Furthermore, it provides a comprehensive overview of the surgical techniques involved in SG and RYGB, addresses potential complications, and presents findings from key studies on the weight loss and metabolic outcomes of these surgeries. Additionally, to support clinical application, the review provides outcome data for these procedures based on studies conducted in Korean populations. In addition to SG and RYGB, this review briefly introduces other surgical and endoscopic options, as well as pharmacological treatments that are currently available or may become viable options in the near future.

摘要

病态肥胖需要积极干预,治疗选择包括生活方式改变、药物治疗和手术。随着韩国肥胖患病率持续上升,专科医生和全科医生全面了解肥胖及其管理至关重要。减重手术是治疗肥胖最有效的方式,能带来显著的体重减轻和代谢益处。它涉及对正常解剖结构进行手术改变以改善整体健康。因此,根据患者个体特征选择合适的手术方法至关重要。本综述重点介绍了全球(包括韩国)最常施行的两种减重手术:袖状胃切除术(SG)和Roux-en-Y胃旁路术(RYGB)。此外,它全面概述了SG和RYGB所涉及的手术技术,阐述了潜在并发症,并展示了关于这些手术的体重减轻和代谢结果的关键研究结果。此外,为支持临床应用,本综述基于在韩国人群中开展的研究提供了这些手术的结果数据。除了SG和RYGB,本综述还简要介绍了其他手术和内镜治疗选择,以及目前可用或在不久的将来可能成为可行选择的药物治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c47/11725483/efe93457309c/kjim-2024-219f1.jpg

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