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中华普外科手术学杂志(电子版) ›› 2025, Vol. 19 ›› Issue (03) : 349 -352. doi: 10.3877/cma.j.issn.1674-3946.2025.03.031.

综述

肥胖症患者袖状胃切除术后体重反弹的相关因素分析
陆嘉杰1, 严帅1, 蔡卫华2, 吴金柱2,()   
  1. 1. 226001 江苏南通,南通大学医学院
    2. 226001 江苏南通,南通大学附属南通第三医院肝胆外科
  • 收稿日期:2024-07-05 出版日期:2025-06-26
  • 通信作者: 吴金柱

Analysis of the related factors of weight rebound after sleeve gastrectomy in patients with obesity

Jiajie Lu1, Shuai Yan1, Weihua Cai2, Jinzhu Wu2,()   

  1. 1. Medical School of Nantong University,Nantong Jiangsu Province 226001,China
    2. Deparment of Hepatobiliary Surgery,Nantong Third Hospital Affiliated to Nantong University,Nantong Jiangsu Province 226001,China
  • Received:2024-07-05 Published:2025-06-26
  • Corresponding author: Jinzhu Wu
引用本文:

陆嘉杰, 严帅, 蔡卫华, 吴金柱. 肥胖症患者袖状胃切除术后体重反弹的相关因素分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 349-352.

Jiajie Lu, Shuai Yan, Weihua Cai, Jinzhu Wu. Analysis of the related factors of weight rebound after sleeve gastrectomy in patients with obesity[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(03): 349-352.

肥胖症近年来发病率呈持续上升趋势,手术为主的综合治疗可使患者获得较好预后,但其手术治疗后仍有复发风险。现有针对肥胖症患者经袖状胃切除术后体重反弹的研究相对较少,本文综述肥胖症患者袖状胃切除术后体重反弹的研究现状,从解剖因素、激素因素、运动、心理状态、术前减重措施与术后体重减轻程度等多方面总结复发高危因素,对现有的复发预测模型进行评价,以期为广大临床医生对于肥胖症的治疗提供参考与借鉴。

In recent years,the incidence of obesity has been on a continuous upward trend.Comprehensive treatment mainly based on surgery can enable patients to achieve a relatively good prognosis,but there is still a risk of recurrence after surgical treatment.Currently,there are relatively few studies on the weight rebound in obese patients after sleeve gastrectomy.This article reviews the current research status of weight rebound in obese patients after sleeve gastrectomy,summarizes the high-risk factors for recurrence from multiple aspects such as anatomical factors,hormonal factors,exercise,psychological state,preoperative weight loss measures,and the degree of postoperative weight loss,and evaluates the existing recurrence prediction models,with the aim of providing reference for clinicians in the treatment of obesity.

[1]
Perdomo CM,Cohen RV,Sumithran P,et al.Contemporary medical,device,and surgical therapies for obesity in adults[J].LANCET,2023,401(10382): 1116-1130.
[2]
Lauby-Secretan B,Scoccianti C,Loomis D,et al.Body fatness and cancer-viewpoint of the IARC Working Group[J].NEW ENGL J MED,2016,375(8): 794-798.
[3]
Afshin A,Forouzanfar MH,Reitsma MB,et al.Health effects of overweight and obesity in 195 countries over 25 years[J].NEW ENGL J MED,2017,377(1): 13-27.
[4]
WHO.Obesity and cancer.In: WHO European Regional Obesity Report 2022.Copenhagen: WHO Regional Office for Europe,2022: 132-141.
[5]
Vranesic Bender D,Krznaric Z.et al.Nutritional and behavioral modification therapies of obesity: facts and fiction[J].DigDis,2012,30(2): 163-167.
[6]
王跃东.袖状胃切除术治疗肥胖症[J].浙江医学,2018,40(24): 2621-2623.
[7]
Arterburn DE,Telem DA,Kushner RF,et al.Benefits and risks of bariatric surgery in adults: a review[J].JAMA,2020,324(9):879-887.
[8]
Voorwinde V,et al.Definitions of long-term weight regain and their associations with clinical outcomes[J].Obes Surg,2020,30(2): 527-536.
[9]
Nedelcu M,Khwaja HA,Rogula TG.et al.Weight regain after bariatric surgery-how should it be defined?[J].Surg Obes Relat Dis,2016,12(5): 1129-1130.
[10]
Lauti M,Lemanu D,Zeng ISL,et al.Definition determines weight regain outcomes after sleeve gastrectomy[J].Surg Obes Relat Dis,2017,13(7): 1123-1129.
[11]
Shantavasinkul PC,Omotosho P,Corsino L,et al.Predictors ofweight regain in patients who underwent Roux-en-Y gastric bypass surger[yJ].Surg Obes Relat Dis,2016,12(9): 1640-1645.
[12]
Bradley LE,Forman EM,Kerrigan SG,et al.A pilot study of anacceptance-based behavioral intervention for weight regain after bariatric surgery[J].Obes Surg,2016,26(10): 2433-2441.
[13]
Bradley LE,Forman EM,Kerrigan SG,et al.Project HELP:aremotely delivered behavioral intervention for weight regain after bariatric surgery[J].Obes Surg,2017,27(3): 586-598.
[14]
Odom J,Zalesin KC,Washington TL,et al.Behavioral predictorsof weight regain after bariatric surgery[J].Obes Surg,2010,20(3): 349-356.
[15]
Himes SM,Grothe KB,Clark MM,et al.Stop regain: a pilot psychological intervention for bariatric patients experiencing weight regain[J].Obes Surg,2015,25(5): 922-927.
[16]
Athanasiadis DI,Martin A,Kapsampelis,et al.Factors associated with weight regain post-bariatric surgery: a systematic review[J].SURG ENDOSC,2021,35(8): 4069-4084.
[17]
赵杰,焦宇文,钱峻,等.肥胖症患者腹腔镜袖状胃切除术后体质量反弹的危险因素分析及列线图模型的构建[J].中华胃肠外科杂志,2022,25(10): 913-920.
[18]
El Ansari W,Elhag W.et al.913Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions,Prevalence,Mechanisms,Predictors,Prevention and Management Strategies,and Knowledge Gaps-a Scoping Review[J].OBES SURG,2021,31(4): 1755-1766.
[19]
King WC,Hinerman AS,Belle SH,et al.Comparison of the Performance of Common Measures of Weight Regain After Bariatric Surgery for Association With Clinical Outcomes[J].JAMA-J AM MED ASSOC,2018,320(15): 1560-1569.
[20]
Lauti M,Kularatna M,Hill AG,et al.Weight regain following sleeve gastrectomy-a systematic review [J].Obesity surgery,2016,26: 1326-1234.
[21]
Lauti M,Lemanu D,Zeng ISL,et al.Definition determines weight regain outcomes following sleeve gastrectomy[J].SURG OBES RELAT DIS,2017,12(5): 1129-1130.
[22]
闫文貌,白日星.减重代谢术后体重反弹的原因和防治措施[J].外科理论与实践,2017,12(05): 112-120.
[23]
Abu Dayyeh BK,Lautz DB,Thompson CC.Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass[J].Clin Gastroenterol Hepatol,2011,9: 228-233.
[24]
Santo MA,Riccioppo D,Pajecki D,et al.Weight regain after gastric bypass: influence of gut hormones[J].Obes Surg,2019,26: 919-925.
[25]
Abu Dayyeh BK,Jirapinyo P,Thompson CC,et al.Plasma ghrelin levels and weight regain after Roux-en-Y gastric bypass surgery[J].Obes Surg,2014,27: 1031-1036.
[26]
Conceicao E,Mitchell JE,Vaz AR,et al.The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: importance of picking or nibbling on weight regain[J].Eat Behav,2014,15: 558-562.
[27]
Cooper TC,Simmons EB,Webb K,et al.Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery[J].Obes Surg ,2015,25: 1474-1481.
[28]
Livhits M,Mercado C,Yermilov I,et al.Patient behaviors associated with weight regain after laparoscopic gastric bypass[J].Obes Res Clin Pract,2011,5: e169-266.
[29]
Amundsen T,Strommen M,Martins.Suboptimal weight loss and weight regain after gastric bypass surgery-postoperative status of energy intake,eating behavior,physical activity,and psychometrics[J].Obes Surg,2019,27: 1316-1323.
[30]
Yanos BR,Saules KK,Schuh LM,et al.Predictors of lowest weight and long-term weight regain among Roux-en-Y gastric bypass patients[J].Obes Surg,2015,25: 1364-1370.
[31]
Alvarez V,Carrasco F,Cuevas A,et al.Mechanisms of longterm weight regain in patients undergoing sleeve gastrectomy[J].Nutrition,2015,32: 303-308.
[32]
Bastos EC,Barbosa EM,Soriano GM,et al.Determinants of weight regain after bariatric surgery[J].ABCD-ARQ BRAS CIR DI,2013,26 Suppl 1: 26-32.
[33]
da Silva FB,Gomes DL,de Carvalho KM.Poor diet quality and postoperative time are independent risk factors for weight regain after Roux-en-Y gastric bypass[J].Nutrition,2016,32: 1250-1253.
[34]
Abu Dayyeh BK,Lautz DB,Thompson CC et al.Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass[J].Clin Gastroenterol Hepatol,2010,9: 228-233.
[35]
Nicolau J,Simo R,Sanchis P,Ayala L,et al.Effects of depressive symptoms on clinical outcomes,inflammatory markers and quality of life after a significant weight loss in a bariatric surgery sample[J].Nutr Hosp,2016,34: 81-87.
[36]
Varma S,Clark JM,Schweitzer M et al.Weight regain in patients with symptoms of post-bariatric surgery hypoglycemia[J].Surg Obes Relat Dis,2017,13: 1728-1734.
[37]
Monaco-Ferreira DV,Leandro-Merhi VA.Weight regain 10 years after Roux-en-Y gastric bypass[J].Obes Surg,2018,27: 1137-1144.
[38]
Pellitero S,Perez-Romero N,et al.Baseline circulating ghrelin does not predict weight regain neither maintenance of weight loss after gastric bypass at long term[J].Am J Surg,2014,210:340-344.
[39]
Bakr AA,Fahmy MH,Elward AS,et al.Analysis of medium-term weight regain 5 years after laparoscopic sleeve gastrectomy[J].Obes Surg,2022,29: 3508-3513.
[40]
Farias G,Thieme RD,Teixeira LM et al.Good weight loss responders and poor weight loss responders after Roux-en-Y gastric bypass: clinical and nutritional profiles[J].Nutr Hosp,2014,33: 574.
[41]
Monaco-Ferreira DV.Leandro-Merhi VA Weight regain 10 years after Roux-en-Y gastric bypass[J].Obes Surg,2013,27: 1137-1144.
[42]
Shantavasinkul PC,Omotosho P,Corsino L,et al.Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery[J].Surg Obes Relat Dis,2016,12: 1640-1645.
[43]
Vieira FT,Faria S,Dutra ES,et al.Perception of hunger/satiety and nutrient intake in women who regain weight in the postoperative period after bariatric surgery[J].Obes Surg,2007,29: 958-963.
[44]
Liu SY,Wong SK,Lam CC,et al.Long-term results on weight loss and diabetes remission after laparoscopic sleeve gastrectomy for a morbidly obese Chinese population[J].Obes Surg,2015,25:1901-1908.
[45]
Ciudin A,Fidilio E,Ortiz A et al.Genetic testing to predict weight loss and diabetes remission and long-term sustainability after bariatric surgery: a Pilot Study[J].Clin Med,2013,8: 964.
[46]
Chou JJ,Lee WJ,Almalki O,et al.Dietary intake and weight changes 5 years after laparoscopic sleeve gastrectomy[J].Obes Surg,2017,27: 3240-3246.
[47]
Devlin MJ,King WC,Kalarchian MA,et al.Eating pathology and associations with long-term changes in weight and quality of life in the longitudinal assessment of bariatric surgery study[J].Int J Eat Disord,2019,51: 1322-1330.
[48]
Kofman MD,Lent MR,Swencionis C,et al.Maladaptive eating patterns,quality of life,and weight outcomes following gastric bypass: results of an Internet survey[J].Obesity (Silver Spring),2010,18: 1938-1943.
[49]
Jirapinyo P,Abu Dayyeh BK,Thompson C.Weight regain after Roux-en-Y gastric bypass has a large negative impact on the Bariatric Quality of Life Index [J].BMJ Open Gastroenterol,2017,4: e000153.
[50]
杨宁琍,赵康,花红霞,等.袖状胃切除术后病人体质量指数变化轨迹及其预测因素分析[J].临床外科杂志,2022,30(05):475-478.
[51]
King WC,Belle SH,Hinerman AS,et al.Patient behaviors and characteristics related to weight regain after Roux-en-Y gastric bypass: a multicenter prospective Cohort Study[J].Ann Surg,2012,272: 1044.
[52]
Diamantis T,Apostolou KG,Alexandrou A,et al.Review of longterm weight loss results after laparoscopic sleeve gastrectomy[J].Surg Obes Relat Dis,2013,10: 177-183.
[53]
Bo Yang,Xu Hu,Jinyan He,Ming Xie.Research status of laparoscopic sleeve gastrectomy tube fixation[J].Chinese Journal of Operative Procedures of General Surgery(Electronic Edition),2024,18(04): 452-455.
[54]
Zhang ZT,Zhang P.Overview of the 20 years’ history and future direction of laparoscopic metabolic and bariatric surgery in China[J].Chinese Journal of Operative Procedures of General Surgery(Electronic Edition),2021,15(06): 591-597.
[55]
Shuai Yan,Xu Hu,Xiaomei Gou,Ming Xie.Management strategy of complications after laparoscopic gastric sleeve resection[J].Chinese Journal of Operative Procedures of General Surgery(Electronic Edition),2024,18(02): 220-224.
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