Adipositaschirurgie bei monogenetisch bedingter Adipositas

 

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Zusammenfassung

Die operative Behandlung des krankhaften Übergewichtes bei monogenetisch bedingten Adipositasformen ist der am wenigsten untersuchte Teil der bariatrischen Chirurgie. In dieser Übersichtsarbeit werden die genetischen Aspekte der Adipositas dargestellt und chirurgische Behandlungen ihrer monogenetischen Formen (insbesondere Prader-Willi-Syndrom) diskutiert. Wie bei polygenen Formen der Adipositas werden sowohl magenrestriktive Verfahren wie die Gastroplastik oder das Gastric Banding als auch malabsorptive und kombinierte Verfahren wie die biliopankreatische Diversion oder Roux-en-Y-Magenbypass angewandt. Wegen kleiner Fallzahlen fehlen bis dato evidenzbasierte Ergebnisse. Entscheidungen über die Indikation zur Operation und Wahl des operativen Verfahrens basieren auf empirischen Grundlagen. Die Anwendung von Wachstumshormonen kann möglicherweise die Ergebnisse der Adipositaschirurgie bei monogenetisch bedingtem krankhaftem Übergewicht verbessern.

Abstract

Surgical treatment of patients suffering from monogenetic forms of morbid obesity is considered to be the poorest investigated theme in bariatric surgery. This review article presents aspects of genetic disorders in morbid obesity as well as some aspects of surgical treatment in patients with monogenetic forms of morbid obesity (Prader-Willi-Syndrome). Gastric restrictive procedures such as vertical banded gastroplasty or adjustable gastric banding as well as malabsorptive and mix procedures such as biliopancreatic diversion or Roux-en-Y gastric bypass are used for treatment, similar to polygenetic forms of morbid obesity. Until to now there is no evidence-based data because of the small number of published cases. Decisions about the indication to operation and about the choice of surgical procedures are based on the empiric fundament. It is to suggest that the use of growth hormones in patients with monogenetic forms of morbid obesity could positively influence the results of bariatric surgery in these patients.

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Priv.-Doz. Dr. M. Korenkov

Klinik und Poliklinik für Allgemein- und Abdominalchirurgie · Johannes-Gutenberg-Universität Mainz

Langenbeckstraße 1

55131 Mainz

Email: korenkov@ach.klinik.uni-mainz.de