Der Diabetologe

, Volume 4, Issue 4, pp 252–258 | Cite as

Chancen und Risiken der chirurgischen Adipositastherapie

Metabolische Chirurgie beim Typ-2-Diabetes
Leitthema
  • 79 Downloads

Zusammenfassung

Neue Schlagzeiten gehen um die Welt: „Adipositaschirurgie kann Diabetes heilen“, nachdem die erste randomisierte kontrollierte Studie über die Effektivität des laparoskopisch implantierten steuerbaren Magenbandes (LAGB) auf den Typ-2-Diabetes in JAMA publiziert wurde. Den Adipositaschirurgen ist diese Tatsache seit Jahren wohl bekannt. Aber die jüngste randomisierte Studie zeigt gemeinsam mit der in The New England Journal of Medicine im August 2007 veröffentlichten Langzeitbeobachtung über die lebensverlängernden Effekte der Adipositaschirurgie, dass bariatrische Chirurgie Leben rettet und drastisch Begleit- und Folgeerkrankungen beseitigt oder grundlegend verbessert. Das Risiko der operativen Behandlung ist deutlich geringer als der Fortbestand der Adipositas mit einem metabolischen Syndrom. Die operative Intervention ist die effektivste Behandlung des Diabetes mellitus bei Übergewicht und Adipositas.

Schlüsselwörter

Adipositas Typ-2-Diabetes Operation Magenchirurgie 

Risks and prospects of obesity surgery

Metabolic surgery in type 2 diabetes

Abstract

News headlines around the world read “Obesity Surgery Can Cure Diabetes” following the first randomized controlled study of the effect of laparoscopic adjustable gastric banding (LAGB) on type 2 diabetes was published today in the Journal of the American Medical Association (JAMA). As bariatric and metabolic surgeons we have known this for years, but today’s study, along with the two landmark studies published in The New England Journal of Medicine in August 2007 that showed a significant increase in survival among people who have bariatric surgery, provide new and important evidence that this type of surgery saves lives and can eliminate, or dramatically improve, disease. The risks of the surgery are less than the existing combination of obesity with metabolic syndrome. Surgery in overweight and obese patients is the most effective treatment for diabetes.

Keywords

Obesity Type 2 diabetes Surgery Gastric surgery 

Literatur

  1. 1.
    Adams KF, Schatzkin A, Harris TB et al. (2006) Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 355: 763–778PubMedCrossRefGoogle Scholar
  2. 2.
    Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15: 539–553PubMedCrossRefGoogle Scholar
  3. 3.
    Alberti KG, Zimmet P, Shaw J (2006) Metabolic syndrome – a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 23: 469–480PubMedCrossRefGoogle Scholar
  4. 4.
    Buchwald H, Avidor Y, Braunwald E et al. (2004) Bariatric surgery: a systematic review and metaanalysis. JAMA 142: 547–559Google Scholar
  5. 5.
    Christou N, Sampalis J, Liberman M et al. (2004) Surgery decreases long-term motarlity, morbidity and health care use in morbidly obese patients. Ann Surg 240: 416–424PubMedCrossRefGoogle Scholar
  6. 6.
    Dixon JB, Obrien PE, Playfair J et al. (2008) Summary and implications of adjustable gastric banding and conventional therapy for type 2 diabetes. A randomized controlled trial. JAMA 299: 316–323PubMedCrossRefGoogle Scholar
  7. 7.
    International Association for the Study of Obesity/IASO (2007) Adult overweight and obesity in the European Union. London. http://www.iotf.org/documents/Europeandatatable_000.pdfGoogle Scholar
  8. 8.
    Maggard MA, Sugarman LR, Suttorp M et al. (2005) Metaanalysis: surgical treatment of obesity. Ann Intern Med 142: 547–559PubMedGoogle Scholar
  9. 9.
    National Cholesterol Education Program/NCEP (2000) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment Panel III). Third report, final report. Circulation 106: 3143–4321Google Scholar
  10. 10.
    Parikh M, Ayoung-Chee P, Romanos E et al. (2007) Comparison of rates of resolution of diabetes mellitus after gastric banding, gastric bypass, and biliopancreatic diversion. J Am Coll Surg 205: 631–635PubMedCrossRefGoogle Scholar
  11. 11.
    Rubino F, Marescaux J (2004) Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes. A new perspective for an old disease. Ann Surg 289: 233–243Google Scholar
  12. 12.
    Sjöström L, Narbro K, Sjöström CD et al. Swedish Obese Subjects Study (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357: 741–752PubMedCrossRefGoogle Scholar
  13. 13.
    WHO (2000) Obesity: Preventing and managing the global epidemic – Report of a WHO Consultation on Obesity. Technical report Series 894. WHO, GenevaGoogle Scholar
  14. 14.
    Weiner R (2006) Adipositaschirurgie – Indikationen und Therapieverfahren. UNIMED, Bremen New YorkGoogle Scholar
  15. 15.
    Weiner R, Weiner S, Pomhoff I et al. (2007) Laparoscopic sleeve gastrectomy – influence of sleeve size and resected gastric volume. Obes Surg 17: 297–305Google Scholar
  16. 16.
    Weiner R (in Druck) Schlauchmagenbildung. Adipositas 2Google Scholar
  17. 17.
    Weiner R (2008) Adipositaschirurgie. Effektive Therapie der morbiden Adipositas und ihrer Begleiterkrankungen. Med Welt 59: 32–37Google Scholar

Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Chirurgische KlinikKrankenhaus SachsenhausenFrankfurt am MainDeutschland

Personalised recommendations