PMID- 22746072
OWN - NLM
STAT- MEDLINE
DCOM- 20120807
LR  - 20171116
IS  - 0035-9351 (Print)
IS  - 0035-9351 (Linking)
VI  - 91
IP  - 1
DP  - 2012 Jan
TI  - [Contemporary overview of the bariatric-metabolic surgery].
PG  - 5-11
AB  - INTRODUCTION: The increasing prevalence of obesity and type 2 diabetes mellitus 
      (T2DM) worldwide may nowadays be regarded as a "twin" metabolic pandemic, causing 
      the number of patients with the metabolic syndrome (MS) to rise rapidly. MS is a 
      combination of several interrelated medical disorders such as obesity, T2DM, 
      hypertension, dyslipidaemia etc. These conditions very frequently result in 
      atherosclerosis, ischaemic heart disease, liver steatosis or even steatofibrosis. 
      MS usually causes a significant worsening of the quality of life, often also 
      leading to shortened life span. Bariatric, also referred to as metabolic (B-M), 
      surgery currently represents a very powerful method for the treatment of morbid 
      obesity and the metabolic syndrome. METHODS: Contemporary bariatric-metabolic 
      surgery uses either restrictive or malabsorptive methods, or a combination 
      thereof. The purely restrictive procedures may include for instance adjustable 
      gastric banding (AGB), and more recently also vertical gastric greater curvature 
      plication. According to some authors, the purely restrictive methods include 
      sleeve gastrectomy (SG); this procedure, besides restriction and a faster 
      emptying of the residual stomach, has been proven to involve a hormonal effect 
      (decreased plasma ghrelin level). Methods such as biliopancreatic diversion by 
      Scopinaro (BPD/S) or its duodenal switch modification (BPD/DS), are regarded as 
      purely malabsorptive. The Roux-en-Y gastric bypass (RYGBP), the most commonly 
      used type of bypass surgery, represents a combination (restrictive-malabsorptive) 
      method. RESULTS: According to Buchwald's meta-analysis, the total average weight 
      loss after a B-M surgery was 38.5 kg, or 55.9% EBWL (Excess Body Weight Loss), 
      regardless of the method and timing of the operation. Up to 2 years after the 
      procedure, the average weight loss was 36.6 kg, or 53.8% EBWL, and more than 2 
      years after the procedure, the average weight loss was 41.2 kg, or 59% EBWL. T2DM 
      was improved or resolved after the operation in 86.6% of cases. The best results 
      of T2DM treatment were achieved after BPD/DS (95.1%). T2DM resolved after GBP in 
      80.3%, after SG in 75.8% and after AGB in 56.7% of obese diabetics. CONCLUSION: 
      Treatment options for the metabolic syndrome include bariatric-metabolic surgery, 
      preferably using the mini-invasive laparoscopic method. These procedures are 
      indicated primarily in morbidly obese patients with BMI > 40 kg/m2 after 
      conservative therapy failure, or patients with severe obesity (BMI > 35 kg/m2) 
      associated with serious circulatory, metabolic or mobility complications. 
      Moreover, surgical treatment of T2DM has been proven to be possible in the last 
      decade.
FAU - Kasalicky, M
AU  - Kasalicky M
AD  - Chirurgicka klinika 2. LF UK a UVN-VFN. mojmir.kasalicky@unv.cz
LA  - cze
PT  - Journal Article
PT  - Review
TT  - Pohled na soucasnou bariatricko-metabolickou chirurgii.
PL  - Czech Republic
TA  - Rozhl Chir
JT  - Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti
JID - 9815441
SB  - IM
MH  - Bariatric Surgery/*methods
MH  - Diabetes Mellitus, Type 2/surgery
MH  - Humans
MH  - Metabolic Syndrome/surgery
MH  - Obesity/surgery
EDAT- 2012/07/04 06:00
MHDA- 2012/08/08 06:00
CRDT- 2012/07/04 06:00
PHST- 2012/07/04 06:00 [entrez]
PHST- 2012/07/04 06:00 [pubmed]
PHST- 2012/08/08 06:00 [medline]
PST - ppublish
SO  - Rozhl Chir. 2012 Jan;91(1):5-11.