减重代谢手术历史、现状及探索型术式研究进展

History,current paradigm and research progress of bariatric/metabolic surgery

国内成人超重和肥胖症的患病率分别为34.3%和16.4%。减重代谢手术可通过限制营养吸收或调节代谢等方式来缓解病态肥胖,从而减少肥胖相关并发症如2型糖尿病、高血压等,提高患者的生存质量。目前的主流术式为袖状胃切除术、Roux-en-Y胃旁路术等,其他探索型术式如腹腔镜袖状胃切除联合手术、胃内球囊术等也不断发展。该文对减重代谢手术术式进展及优劣作一综述,以期给患者提供个性化治疗方案,为临床医生提供更多的选择。

In China,the prevalence of overweight and obesity among adults is 34.3%and 16.4%respectively.Bariatric/metabolic surgery can effectively relieve morbid obesity by limiting nutrient absorption or regulating metabolism,consequently reducing obesity-related complications such as type 2 diabetes and hypertension and improving the quality of life for patients.Currently,the mainstream surgical methods are sleeve gastrectomy,Roux-en-Y gastric bypass,etc.Other new exploratory surgical methods,including combined laparoscopic sleeve gastrectomy,intragastric balloon,etc.,are also undergoing continuous development.Here we reviewed the evolution of mainstream and emerging exploratory methods for bariatric/metabolic surgeries and discussed the merits and limitations of individual surgical methods,in aim to provide clinicians with more options for individualized treatment strategy for patients.