When it comes to surgery, people will think that it is a way to fundamentally solve the disease. With the advancement and general progress of bariatric surgery, surgery seems to be "good news for lazy people." But is this really the case? Can I just eat and drink a lot before and after surgery and then lie down to achieve my ideal results?
The smooth implementation of an operation and the achievement of expected results involve many factors, including preoperative patient preparation, surgery, good anesthesia, the surgeon's intraoperative operations, postoperative patient management, etc. Bariatric surgery also No exception.
Current representatives of bariatric surgery include adjustable gastric banding, gastric sleeve resection, biliopancreatic diversion-duodenal switch, and Roux-en-Y gastric bypass.
Sleeve gastrectomy is what we usually call gastric reduction surgery . Its main principle is to limit the absorption of nutrients by the digestive tract, thereby achieving weight loss.
Obese patients are often accompanied by hypertension , dyslipidemia and type Ⅱ diabetes, also known as metabolic syndrome, which increases the risk of surgery. Metabolic syndrome is an independent predictor of cardiac dysfunction and cardiovascular disease and a risk factor for surgical morbidity and mortality. 【1】
For anesthesiologists, obesity also poses considerable challenges, including:
(1) Difficulty in intravenous insertion (2) Tracheal intubation (3) Risk of obesity-related comorbidities (4) Postoperative complications risk of disease [1].
Therefore, patients should take action before surgery. Preoperative weight loss can not only reduce body weight [2], but also effectively reduce liver volume and visceral fat content [3, 4], reduce surgical risks, reduce intraoperative bleeding, and shorten surgical time [5]. At the same time, the postoperative weight loss effect is also better [6].
Postoperative patients should also pay attention to their diet. It is recommended that the protein intake of patients after weight loss surgery is 60~80g/d [7]. At the same time, we should also pay attention to the supplement of multivitamin (especially vitamin B and vitamin D) and trace elements such as iron, zinc, and magnesium.
At the same time, you should try to go out as much as possible in your daily life, control your eating behavior, and reduce your bad living habits and negative emotions.
Weight loss relies not only on modern medical technology, but also on your own strong willpower, positivity in your inner world, and a long-term comprehensive weight loss maintenance plan.
【1】Pouwels S, Buise MP, Twardowski P, Stepaniak PS, Proczko M. Obesity Surgery and Anesthesiology Risks: a Review of Key Concepts and Related Physiology. Obes Surg. 2019 Aug;29(8):2670-2677. doi : 10.1007/s11695-019-03952-y. PMID: 31127496.
【2】CARBAJO M A, CASTRO M J, KLEINFINGER S, et al. Effects of a balanced energy and high protein formula diet (Vegestart complet®) vs. low- Calorie regular diet in morbid obese patients prior to bariatric surgery (laparoscopic single anastomosis gastric bypass): a prospective, double-blind rando-mized study[J]. Nutr Hosp, 2010, 25(6):939-948.
[3 】GONZÁLEZ-PÉREZ J, SÁNCHEZ-LEENHEER S, DELGADO A R, et al. Clinical impact of a 6-week preoper-ative very low calorie diet on body weight and liver size in mor-bidly obese patients[J]. Obes Surg, 2013, 23(10):1624-1631.
【4】FRIS R J. Preoperative low energy diet diminishes liver size[J]. Obes Surg, 2004, 14(9):1165-1170.
VAN NIEUWENHOVE Y, DAMBRAUSKAS Z , CAMPILLO-SOTO A, et al. Preoperative very low-calorie diet and operativ
【5】outcome after laparoscopic gastric bypass: a randomized multicenter study[J]. Arch Surg, 2011, 146(11):1300-1305.
【 6】HUTCHEON D A, HALE A L, EWING J A, et al. Short-Term Preoperative Weight Loss and Postoperative Outcomes in Bariatric Surgery[J]. J Am Coll Surg, 2018, 226(4):514-524.
【7】 Nutrition and Metabolism Collaboration Group of the Parenteral and Enteral Nutrition Branch of the Chinese Medical Association, and the Weight Loss Multidisciplinary Collaboration Group of Peking Union Medical College Hospital. Expert consensus on nutrition and multidisciplinary management of bariatric surgery[J]. Chinese Journal of Surgery , 2018, 56 (2): 81-90.
