Zusammenfassung
Adipositas ist die häufigste Form der Fehlernährung und morbide Adipositas stellt ein Ernst zu nehmendes Gesundheits- und sozioökonomisches Problem dar. Das praktisch völlige Versagen konservativer Therapiemaßnahmen in Bezug auf eine dauerhafte Reduktion des Körpergewichtes bei morbid Adipösen hat zur Entwicklung operativer Behandlungsmethoden schon seit Mitte des 20. Jahrhunderts geführt. Eine Unzahl verschiedener Operationstechniken wurde entwickelt und vorgeschlagen. Im Prinzip können die Eingriffe unterteilt werden in solche, die zu einer Malabsorption unterschiedlichen Grades führen und solche, die die Nahrungsaufnahme einschränken, aber auch die Kombination beider Verfahren ist möglich. Eine handvoll Techniken haben sich innerhalb der letzten 30 Jahre durchgesetzt, die meisten davon werden laparoskopisch durchgeführt. Die schrittweise Entwicklung dieser chirurgischen Subdisziplin wird geschildert und die Langzeitergebnisse dargelegt. Die bariatrische Chirurgie ist risikoarm, sicher und bis jetzt mehr langzeitwirksam als alle anderen Methoden, die zur Behandlung der extremen Übergewichtigkeit angewandt werden.
Abstract
Obesity is the most common form of malnutrition and morbid obesity is increasingly recognized as a major health concern. Drug treatments of the morbid obese have entirely failed in the long run. These circumstances have constituted incentives for surgeons to develop techniques resulting in malabsorptive or restrictive effects on food intake. Several techniques achieve weight loss through both these mechanisms and most likely also by changing the gastrointestinal signalling system. Within the last 50 years surgery for morbid obesity has been developed stepwise, like other surgical methods. More than 50 surgical anti-obesity techniques have been described. Half a dozen techniques have been left over and are performed mainly laparoscopically now a days. The outcome of these techniques over the last 30 years is reported in this article. It is the aim to illustrate that bariatric surgery is safe and so far more long-term efficient than any other technique available for the treatment of morbid obesity.
Schlüsselwörter
Adipositas - morbid - historische Entwicklung - derzeitiger Stand - zukünftige Entwicklung
Key words
Obesity - morbid - historical development - state of the art - future development
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Univ.-Prof. Dr. Emanuel Hell
Am Sonnenlehen 395
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