Manejo operatorio de la obesidad
Surgical treatment of obesity: a review.
Fobi MA.
Center for Surgical Treatment of Obesity, Hawaiian Gardens, CA 90716, USA. info@cstobesity.com
J Natl Med Assoc. 2004 Jan;96(1):61-75.
Abstract
Obesity is a chronic disease due to excess fat storage, a genetic predisposition, and strong environmental contributions. This problem is worldwide, and the incidence is increasing daily. There are medical, physical, social, economic, and psychological comorbid conditions associated with obesity. There is no cure for obesity except possibly prevention. Nonsurgical treatment has been inadequate in providing sustained weight loss. Currently, surgery offers the only viable treatment option with longterm weight loss and maintenance for the morbidly obese. Surgeries for weight loss are called bariatric surgeries. There is no one operation that is effective for all patients. Gastric bypass operations are the most common operations currently used. Because there are inherent complications from surgeries, bariatric surgeries should be performed in a multidisciplinary setting. The laparoscopic approach is being used by some surgeons in performing the various operations. The success rate--usually defined as >50% excess weight loss that is maintained for at least five years from bariatric surgery--ranges from 40% in the simple to >70% in the complex operations. The weight loss from surgical treatment results in significant improvements and, in some cases, complete resolution of comorbid conditions associated with obesity. Patients undergoing surgery for obesity need lifelong nutritional supplements and medical monitoring.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594758/pdf/jnma00301-0063.pdf
¿Solución rápida o cura a largo plazo? Pros y contras de la cirugía bariátrica
Quick fix or long-term cure? Pros and cons of bariatric surgery.
Madura JA 2nd, Dibaise JK.
Division of General Surgery Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ, USA 85259.
F1000 Med Rep. 2012;4:19. doi: 10.3410/M4-19. Epub 2012 Oct 2.
Abstract
The past decade has seen an enormous increase in the number of bariatric, or weight loss, operations performed. This trend is likely to continue, mirroring the epidemic of obesity around the world and its rising prevalence among children. Bariatric surgery is considered by many to be the most effective treatment for obesity in terms of maintenance of long-term weight loss and improvement in obesity-related comorbid conditions. Although overly simplified, the primary mechanisms of the surgical interventions currently utilized to treat obesity are the creation of a restrictive or malabsorptive bowel anatomy. Operations based on these mechanisms include the laparoscopic adjustable gastric band and laparoscopic vertical sleeve gastrectomy (considered primarily restrictive operations), the laparoscopic biliopancreatic diversion with or without a duodenal switch (primarily malabsorptive operation), and the laparoscopic Roux-en-Y gastric bypass (considered a combination restrictive and selective malabsorptive procedure). Each operation has pros and cons. Important considerations, for the patient and surgeon alike, in the decision to proceed with bariatric surgery include the technical aspects of the operation, postoperative complications including long-term nutritional problems, magnitude of initial and sustained weight loss desired, and correction of obesity-related comorbidities. Herein, the pros and cons of the contemporary laparoscopic bariatric operations are reviewed and ongoing controversies relating to bariatric surgery are discussed: appropriate patient selection, appropriate operation selection for an individual patient, surgeon selection, and how to measure success after surgery.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/pdf/medrep-04-19.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Surgical treatment of obesity: a review.
Fobi MA.
Center for Surgical Treatment of Obesity, Hawaiian Gardens, CA 90716, USA. info@cstobesity.com
J Natl Med Assoc. 2004 Jan;96(1):61-75.
Abstract
Obesity is a chronic disease due to excess fat storage, a genetic predisposition, and strong environmental contributions. This problem is worldwide, and the incidence is increasing daily. There are medical, physical, social, economic, and psychological comorbid conditions associated with obesity. There is no cure for obesity except possibly prevention. Nonsurgical treatment has been inadequate in providing sustained weight loss. Currently, surgery offers the only viable treatment option with longterm weight loss and maintenance for the morbidly obese. Surgeries for weight loss are called bariatric surgeries. There is no one operation that is effective for all patients. Gastric bypass operations are the most common operations currently used. Because there are inherent complications from surgeries, bariatric surgeries should be performed in a multidisciplinary setting. The laparoscopic approach is being used by some surgeons in performing the various operations. The success rate--usually defined as >50% excess weight loss that is maintained for at least five years from bariatric surgery--ranges from 40% in the simple to >70% in the complex operations. The weight loss from surgical treatment results in significant improvements and, in some cases, complete resolution of comorbid conditions associated with obesity. Patients undergoing surgery for obesity need lifelong nutritional supplements and medical monitoring.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594758/pdf/jnma00301-0063.pdf
¿Solución rápida o cura a largo plazo? Pros y contras de la cirugía bariátrica
Quick fix or long-term cure? Pros and cons of bariatric surgery.
Madura JA 2nd, Dibaise JK.
Division of General Surgery Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ, USA 85259.
F1000 Med Rep. 2012;4:19. doi: 10.3410/M4-19. Epub 2012 Oct 2.
Abstract
The past decade has seen an enormous increase in the number of bariatric, or weight loss, operations performed. This trend is likely to continue, mirroring the epidemic of obesity around the world and its rising prevalence among children. Bariatric surgery is considered by many to be the most effective treatment for obesity in terms of maintenance of long-term weight loss and improvement in obesity-related comorbid conditions. Although overly simplified, the primary mechanisms of the surgical interventions currently utilized to treat obesity are the creation of a restrictive or malabsorptive bowel anatomy. Operations based on these mechanisms include the laparoscopic adjustable gastric band and laparoscopic vertical sleeve gastrectomy (considered primarily restrictive operations), the laparoscopic biliopancreatic diversion with or without a duodenal switch (primarily malabsorptive operation), and the laparoscopic Roux-en-Y gastric bypass (considered a combination restrictive and selective malabsorptive procedure). Each operation has pros and cons. Important considerations, for the patient and surgeon alike, in the decision to proceed with bariatric surgery include the technical aspects of the operation, postoperative complications including long-term nutritional problems, magnitude of initial and sustained weight loss desired, and correction of obesity-related comorbidities. Herein, the pros and cons of the contemporary laparoscopic bariatric operations are reviewed and ongoing controversies relating to bariatric surgery are discussed: appropriate patient selection, appropriate operation selection for an individual patient, surgeon selection, and how to measure success after surgery.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/pdf/medrep-04-19.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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