[Indications and contraindications for surgical treatment of morbid obesity--the choice of operative method].
Surgery for morbid obesity should be considered in case of failure of conservative treatment (diet, physical activity, psychotherapy, supportive medications). It is strongly recommended also for patients with significant concomitant diseases (e.g. cardiovascular, pulmonary etc) difficult to manage with traditional therapy. Patients' selection for surgery seems to be essential issue. Typical indications for surgical procedure include: BMI > 40 or BMI > 35 in patients with at least two obesity-related diseases, ineffective conservative treatment. Main contraindications are GI tract diseases (esophagitis, peptic ulcer), severe cardiovascular insufficiency, alcohol or drug abuse and mental disorders. There are two types of operative procedures currently performed restrictive and malabsorptive. The first group consists of following operations: 1) Silicon Ring Vertical Gastroplasty (SRVG), 2) Vertical Banded Gastroplasty (VBG), 3) Adjustable Silicon Gastric Banding (ASGB), 4) Non-Adjustable Gastric Banding (NGB). The latter group comprises: 1) Roux-Y Gastric By-Pass (RYGB) and 2) Bilipancreatic diversion. The paper describes complications, advantages and disadvantages for both groups of bariatric procedures and points out factors that should be considered in patients' selection for various types of operation.
Paśnik
Krzysztof
K
Klinika Chirurgii Ogólnej, Onkologicznej i Torakochirurgii CSK MON WIM, Warszawa.
Krupa
Jarosław
J
Stanowski
Edward
E
Lapiński
Janusz
J
Zareba
Zbigniew
Z
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002755:Choice Behavior; D000075202:Contraindications; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*