Résumé
L’idée de faire maigrir les patients avant une chirurgie bariatrique n’est pas nouvelle et avait été proposée, dès 1986, pour diminuer le volume hépatique et améliorer la stéatose hépatique. Le but de ce travail a été d’évaluer les données objectives disponibles concernant l’amaigrissement préopératoire avant chirurgie bariatrique. Si pour le chirurgien les bénéfices de l’amaigrissement semblent intuitivement intéressants, les données actuelles ne permettent aucune conclusion définitive (principalement en ce qui concerne la morbidité, la durée opératoire et la durée d’hospitalisation). Il semble néanmoins qu’un amaigrissement préopératoire soit souhaitable pour les patients superobèses (IMC > 50 kg/m2), mais cette option doit alors être mise en balance avec la stratégie chirurgicale en deux temps (par exemple: sleeve gastectomy puis courtcircuit gastrique).
Abstract
Getting patients to lose weight before bariatric surgery is not a new idea — it was first mooted in 1986 as a way of reducing hepatic volume and improving hepatic steatosis. This study aims to assess available objective data with respect to weight loss before bariatric surgery. Although the advantages of weight loss may seem to be obvious from the surgeon’s point of view, current available data does not allow any clear cut conclusions to be drawn (concerning morbidity, length of operation and length of hospitalisation). Preoperative weight loss in the super obese patient (BMI > 50 kg/m2), would appear to be desirable, however, but must be associated with two-stage surgery (e.g. sleeve gastectomy followed by gastric bypass).
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Brunaud, L. La perte de poids avant chirurgie: le point de vue du chirurgien. Obes 3, 163–166 (2008). https://doi.org/10.1007/s11690-008-0140-6
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DOI: https://doi.org/10.1007/s11690-008-0140-6