Metabolische Chirurgie

Die metabolische Chirurgie ist aktuell die effektivste Therapie zur Behandlung der morbiden Adipositas und der assoziierten Begleiterkrankungen. Der Beitrag stellt die Operationsverfahren und deren Stellenwert vor.

Schlüsselwörter

Adipositaschirurgie - metabolische Chirurgie - Diabetes mellitus - mikrovaskuläre Komplikationen - makrovaskuläre Komplikationen - nicht alkoholische Fettlebererkrankung

• Literatur

• 1 Hung S, Chen C, Chin W. et al. The long-term risk of cardiovascular events in patients following bariatric surgery compared to a non-surgical population with obesity and the general population: a comprehensive national cohort study. Langenbeckʼs Arch Surg 2021; 406: 189-196
• 2 Carlsson L, Sjöholm K, Jacobson P. et al. Life expectancy after bariatric surgery in the Swedish Obese Subject Study. N Engl J Med 2020; 383: 1535
• 3 Schauer PR, Bhatt DL, Kirwan JP. et al. Bariatric surgery versus intensive medical therapy for diabetes–5-year outcomes. N Engl J Med 2017; 376: 641-651
• 4 Rubino F, Nathan DM, Eckel RH. et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: A joint statement by International Diabetes Organizations. Diabetes Care 2016; 39: 861-877
• 5 Adams LA, Waters OR, Knuiman MW. et al. NAFLD as a risk factor for the development of diabetes and the metabolic syndrome: an eleven-year follow-up study. Am J Gastroenterol 2009; 104: 861-867
• 6 Colquitt JL, Pickett K, Loveman E. et al. Surgery for weight loss in adults. Cochrane Database Syst Rev 2014; (08) CD003641
• 7 Yan Y, Sha Y, Yao G. et al. Roux-en-Y gastric bypass versus medical treatment for type 2 diabetes mellitus in obese patients: a systematic review and meta-analysis of randomized controlled trials. Medicine 2016; 95: e3462
• 8 Deutsche Adipositas-Gesellschaft e.V. (DAG). et al. S3-Leitlinie: Chirurgie der Adipositas und metabolischer Erkrankungen. 2018. Version 2.3. AWMF-Register Nr. 088–001. Im Internet (Stand: 16.06.2022): https://www.awmf.org/uploads/tx_szleitlinien/088-001l_S3_Chirurgie-Adipositas-metabolische-Erkrankugen_2018-02.pdf
• 9 Aminian A, Al-Kurd A, Wilson R. et al. Association of Bariatric Surgery with major adverse liver and cardiovascular outcomes in patients with biopsy-proven nonalcoholic steatohepatitis. JAMA 2021; 326: 2031-2042
• 10 Lassailly G, Caiazzo R, Ntandja-Wandji LC. et al. Bariatric surgery provides long-term resolution of nonalcoholic steatohepatitis and regression of fibrosis. Gastroenterology 2020; 159: 1290-1301.e5
• 11 Stroh C, Hohmann U, Manger T. Prinzipien der Adipositaschirurgie. Internist Prax 2015; 55: 737-746
• 12 Thaher O, Hukauf M, Stroh C. Propensity score matching sleeve gastrectomy vs. gastric bypass with 5 years of follow-up. Obes Surg 2021; 31: 5156-5165
• 13 Peterli R, Wolnerhanssen BK, Peters T. et al. Effect of laparoscopic sleeve gastrectomy vs. laparoscopic roux-en-y-gastric bypass on weight loss in patients with morbid obesity: The SM-BOSS Randomized Clinical Trial. JAMA 2018; 319: 255-265
• 14 Mingrone G, Panunzi S, De Gaetano A. et al. Bariatric surgery versus conventional therapy for type 2 diabetes. N Engl J Med 2012; 366: 1577-1585
• 15 Mingrone G, Panunzi S, de Gaetano A. et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow up on an open-label, single-centre, randomised controlled trial. Lancet 2015; 386: 964-973
• 16 Salminen P, Helmiö M, Ovaska J. et al. Effect of laparoscopic sleeve gastrectomy vs. laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity. The SLEEVEPASS randomized clinical trial. JAMA 2018; 319: 241-254
• 17 Wölnerhanssen B, Peterli R, Hurme S. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: 5-year outcomes of merged data from two randomized clinical trials (SLEEVEPASS and SM-BOSS). Br J Surg 2021; 108: 49-57
• 18 Robert M, Espalieu P, Pelascini E. et al. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomized, open-label, non-inferiority trial. Lancet 2019; 393: 1299-1309
• 19 Sjöström L, Lindroos A, Peltonen P. et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683-2693
• 20 Biertho L, Lebel S, Marceau S. et al. Biliopancreatic diversion with duodenal switch: Surgical Technique and operative care. Surg Clin North Am 2016; 96: 815-826
• 21 Bueter M, le Roux CW. Gastrointestinal hormones, energy balance and bariatric surgery. Int J Obes (Lond) 2011; 35 Suppl 3: S35-S39
• 22 Buhmann H, le Roux CW, Bueter M. The gut-brain axis in obesity. Best Pract Res Clin Gastroenterol 2014; 28: 559-571
• 23 Moreno-Arciniegas A, Falckenheiner-Soria J, Bancalero-De Los Reyes J. et al. The main participation of the enterohormone GLP-1 after bariatric surgery. Minerva Chir 2019; 74: 7-13
• 24 Steinert RE, Feinle-Bisset C, Asarian L. et al. Ghrelin, CCK, GLP-1, and PYY (3-36): Secretory controls and physiological roles in eating and glycemia in health, obesity, and after RYGB. Physiol Rev 2017; 97: 411-463
• 25 Steinert RE, Rehman A, Souto Lima EJ. et al. Roux-en-Y gastric bypass surgery changes fungal and bacterial microbiota in morbidly obese patients – a pilot study. PloS One 2020; 15: e0236936
• 26 Albaugh VL, Banan B, Antoun J. et al. Role of bile acids and GLP-1 in mediating the metabolic improvements of bariatric surgery. Gastroenterology 2019; 156: 1041-1051.e4
• 27 Bozadjieva N, Heppner K, Seeley R. Targeting FXR and FGF19 to treat metabolic diseases – lessons learned from bariatric surgery. Diabetes 2018; 67: 1720
• 28 Debedat J, Sokovska N, Couzpaye M. et al. Long-term relapse of type 2 diabetes after Roux-en-Y gastric bypass: prediction and clinical relevance. Diabetes Care 2018; 41: 2086-2095
• 29 Thereux J, Lesuffleur T, Czernichow S. et al. Association between bariatric surgery and rates of continuation, discontinuation, or initiation of antidiabetes treatment 6 years later. JAMA Surg 2018; 153: 526-533
• 30 Fischer D, Johnson E, Hanreuse S. et al. Association between bariatric surgery and macrovascular disease outcomes in patients with type 2 diabetes and severe obesity. JAMA 2018; 320: 1570-1582
• 31 OʼBrien R, Johnson E, Haneuse S. et al. Microvascular outcomes in patients with diabetes after bariatric surgery versus usual care. Ann Int Med 2018; 169: 300-310
• 32 Billeter A, Scheurlen K, Probst P. et al. Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus. Br J Surg 2018; 105: 168-181
• 33 Serfaty L, Lemoine M. Definition and natural history of metabolic steatosis: clinical aspects of NAFLD, NASH and cirrhosis. Diabetes Metab 2008; 34: 634-637
• 34 Schauer DP, Feigelson HS, Koebnick C. et al. Bariatric surgery and the risk of cancer in a large multisite cohort. Ann Surg 2019; 269: 95-101
• 35 Feigelson HS, Caan B, Weinmann S. et al. Bariatric Surgery is associated with reduced risk of breast cancer in both premenopausal and postmenopausal women. Ann Surg 2020; 272: 1053-1059
• 36 Bailly L, Fabre R, Pradier C. et al. Colorectal cancer risk following bariatric surgery in a nationwide study of French individuals with obesity. JAMA Surg 2020; 155: 395-402
• 37 Hussan H, Patel A, Le Roux M. et al. Rising incidence of colorectal cancer in young adults corresponds with increasing surgical resections in obese patients. Clin Transl Gastroenterol 2020; 11: e00160
• 38 Stroh C, Meyer F, Manger T. Nutritive Defizite und Supplementation nach metabolischer Chirurgie. Chirurg 2016; 87: 762-767
• 39 Almeanazel O, Alanazi F, Alsarra I. et al. Nanotechnology as a tool to overcome the bariatric surgery malabsorption. Saudi Pharm J 2020; 28: 565-573
• 40 Anvari S, Lee Y, Lam M. et al. The effect of bariatric surgery on oral antibiotic absorption: a systematic review. Obes Surg 2020; 30: 2883-2892
• 41 Carlsson LMS, Sjöholm K, Jacobson P. et al. Life Expectancy after bariatric surgery in the Swedish Obese Subjects Study. N Engl J Med 2020; 383: 1535-1543
• 42 Stroh C, Croner R. 16. Studientreffen des GBSR. CHAZ 2020; 10: 537-539