中国实用外科杂志

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减重与代谢手术新术式的现状和未来

朱晒红,崔贝贝,朱利勇   

  1. 中南大学湘雅三医院减重代谢外科,湖南长沙410013
  • 出版日期:2023-05-01

  • Online:2023-05-01

摘要: 肥胖是重要的全球性健康问题。肥胖不仅影响个体健康,还增加社会卫生保健负担和劳动力损失。减重与代谢手术是治疗肥胖最有效的方法。胃袖状切除术联合单吻合口十二指肠-回肠旁路术、单吻合口胃旁路术、胃内球囊置入和内镜胃袖状成形术等减重与代谢手术新术式使减重代谢治疗策略更加丰富多样。在此基础上,未来的减重代谢术式创新关键在于通过各种手术策略重塑多巴胺介导的“食物成瘾”和“享乐饥饿”,而限制摄入仍然是最直接有效的切入点。

关键词: 减重与代谢手术, 胃袖状切除术, 单吻合口十二指肠-回肠旁路术, 单吻合口胃旁路术, 内镜手术

Abstract: The present and future of novel metabolic and bariatric procedures        ZHU Shai-hong, CUI Bei-bei, ZHU Li-yong. Department of Bariatric and Metabolic Surgery, the Third Xiangya Hospital, Central South University,Changsha 410013, China 
Corresponding author: ZHU Shai-hong, E- mail: shzhu@csu.edu.cn
Abstract    Obesity is a significant global health problem. Obesity not only affects individual health but also increases social healthcare burden and workforce loss. Bariatric surgery is the most effective treatment for obesity. The emerging bariatric procedures such as single anastomosis duodenal-ileal bypass with sleeve, one anastomosis gastric bypass, intragastric balloon, and endoscopic sleeve gastroplasty, etc. add to the diversity of bariatric and metabolic treatment strategies. On this basis, the key to the future innovation of bariatric and metabolic procedures lies in the reshaping of dopamine-mediated “food addiction” and “hedonic hunger” through various operative strategies, with restriction of intake remaining the most direct and effective one.

Key words: metabolic and bariatric surgery, sleere gastrectomy, single anastomosis duodenal-ileal bypass, one anastomosis gastric bypass, endoscopic procedures