臨牀消化器内科 Vol.34 No.4(4-3)


特集名 肥満と消化器
題名 肥満の治療 (3) 外科・内視鏡治療
発刊年月 2019年 04月
著者 網木 学 四谷メディカルキューブ減量・糖尿病外科センター
著者 関 洋介 四谷メディカルキューブ減量・糖尿病外科センター
著者 笠間 和典 四谷メディカルキューブ減量・糖尿病外科センター
【 要旨 】 肥満症治療では食事療法や運動療法,薬物療法などの内科治療が一般的に行われるが,高度肥満者では十分な治療効果が得られないことが多い.肥満がより深刻な問題である欧米では,以前より外科治療(減量手術,バリアトリックサージェリー)が広く行われており,2016年には世界で68万件以上の外科治療が行われた.一方,日本では外科治療の件数は未だ少ないものの,2014年に腹腔鏡下スリーブ状胃切除術(laparoscopic sleeve gastrectomy;LSG)が保険収載され,今後,さらに普及が進むものと予想される.本稿では,世界と日本における減量手術の歴史と現状,臨床成績,今後の課題について解説する.
Theme Obesity and Digestive Organ
Title Current Status of Bariatric Surgery in Japan
Author Manabu Amiki Weight Loss Surgery Center, Yotsuya Medical Cube
Author Yosuke Seki Weight Loss Surgery Center, Yotsuya Medical Cube
Author Kazunori Kasama Weight Loss Surgery Center, Yotsuya Medical Cube
[ Summary ] Obesity is a serious health problem that has increased dramatically worldwide. Medical treatment of obesity and its associated comorbidities (e.g, type 2 diabetes mellitus) has been shown to be effective; however, variable responses to treatment, suboptimal compliance, and adverse effects limit the success of medical management strategies, especially in severely obese patients. The surgical treatment of obesity (so‒called bariatric surgery) has shown to result in dramatic weight loss, as well as an improvement of comorbidities in many severely obese patients, and thus, has been widely accepted in western countries. In Japan, the number of bariatric surgery operations is still low; however, it is expected to increase because laparoscopic sleeve gastrectomy has now been accepted and is one of the procedures covered by Japanese national health insurance since 2014. In this article, the history of bariatric surgery, clinical outcomes, adverse events, current status and future perspectives are briefly summarized.
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