随着减重代谢外科不断发展,特殊肥胖病人的减重代谢手术(metabolic and bariatric surgery,MBS)成为临床难以抉择的问题.高风险病人如肝硬化、肾功能不全、老年人或青少年的MBS效果与安全性、术式选择等尚未达成共识,仍需进一步的阐明与验证.该文从特殊体重、特殊年龄、特殊合并症及过渡手术4个方面切入,讨论特殊肥胖病人MBS的风险与收益,总结临床注意事项,以期为特殊病人开展MBS提供参考.
Clinical considerations for special patients undergoing metabolic and bariatric surgery
With rapid advances of metabolic and bariatric surgery(MBS),decision-making process is becoming more and more complex regarding its application in patients with obesity and specific comorbidities.Efficacy and safety of MBS in high-risk cohorts,including those with cirrhosis,renal insufficiency and across an age spectrum from elders to adolescents,has remained controversial subjects.An expert consensus on optimal surgical approaches for these individuals has yet to be established,necessitating further investigations and validations.This paper focused upon the intricacies of conducting MBS in patients with unique metabolic and bariatric profiles.The authors critically assessed the risks and benefits associated with these procedures and offered a comprehensive overview of clinical considerations.There were four major issues of special weight considerations,age-related factors,challenging comorbidities and transitional procedures.The objective was to contribute valuable insights to the existing body of knowledge and aid clinicians in making informed decisions when contemplating MBS for patients with special needs.
Metabolic and bariatric surgeryExtreme obesityAdolescentsCirrhosisOrgan transplant
万方数据
维普
