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引用次数: 0
摘要
背景：2023年，澳大利亚进行了15985例原发性减肥手术，其中袖胃切除术（SG）占80%。与任何其他治疗方法相比，减肥手术提供了更好的长期体重减轻和合并症解决方案，发病率和死亡率低。目的：评价减肥手术的疗效、适应证、预后及远期注意事项。它比较了目前的外科手术，SG， Roux-en-Y胃旁路术（RYGB）和单吻合术胃旁路术（OAGB），以及其他减肥治疗方法，重点关注澳大利亚全科医生的重要方面。讨论：减肥手术仍然是最有效的治疗肥胖的人，最初达到30%的总体重减轻（TWL）和持续的长期结果。SG和RYGB在5年的TWL率相似（23.7% vs 27.2%）。并发症发生率低（1.5-4.8%），手术可显著改善或解决合并症，特别是糖尿病。内窥镜和药物治疗是新兴的替代方法，但缺乏手术的长期疗效。
Background: In 2023, 15,985 primary bariatric operations were performed in Australia, with sleeve gastrectomy (SG) accounting for 80% of cases. Bariatric surgery offers better long-term weight loss and comorbidity resolution compared with any other treatments, with low morbidity and mortality rates.
Objective: This paper evaluates the efficacy, indications, outcomes and long-term considerations of bariatric surgery. It compares the current surgical procedures, SG, Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB), along with alternative weight-loss treatments, focusing on the important aspects for an Australian general practitioner.
Discussion: Bariatric surgery remains the most effective treatment for people with obesity, initially achieving 30% total weight loss (TWL) with sustained long-term outcomes. Both SG and RYGB show similar TWL rates at five years (23.7% vs 27.2%). Complication rates are low (1.5-4.8%), and surgery significantly improves or resolves comorbidities, particularly diabetes. Endoscopic and pharmacological treatments are emerging alternatives but lack the long-term efficacy of surgery.
期刊介绍：
The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.
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