顾岩:如何进一步提高减重手术效果-Bariplastic surgery

2016-06-23 MedSci MedSci原创

2016年6月18日在上海交通大学医学院附属第九人民医院举办了减重和代谢外科论坛,会议邀请到了包括中国医科大学第四临床学院、附属第四医院院长兼党委副书记刘金钢教授、副院长王勇教授、中国人民解放军第二军医大学附属长海医院郑成竹教授、暨南大学第一附属医院副院长王存川教授、中南大学湘雅三院副院长朱晒红教授、上海交通大学附属瑞金医院副院长沈柏用教授、北京世纪坛医院副院长张能维教授等各路专家教授齐聚一堂,共

2016年6月18日在上海交通大学医学院附属第九人民医院举办了减重和代谢外科论坛,会议邀请到了包括中国医科大学第四临床学院、附属第四医院院长兼党委副书记刘金钢教授、副院长王勇教授、中国人民解放军第二军医大学附属长海医院郑成竹教授、暨南大学第一附属医院副院长王存川教授、中南大学湘雅三院副院长朱晒红教授、上海交通大学附属瑞金医院副院长沈柏用教授、北京世纪坛医院副院长张能维教授等各路专家教授齐聚一堂,共同探讨交流关于减重和代谢外科的学科话题,上海交通大学医学院附属第九人民医院普外科主任顾岩教授就“如何进一步提高减重手术效果-Bariplatic surgery”同到场的各路专家教授展开了经验交流。


顾岩教授与参会专家教授合影

肥胖症和糖尿病是危害人类健康的重大公共卫生问题,发病率在不断攀升。为什么要Bariplastic?顾岩教授解答道:减重手术不仅可显著降低病人多余的体重,还能缓解因肥胖带来的各种代谢疾病;但大多数病人在体重下降后,相对过多的皮肤带来的困扰伴随而来,不仅严重影响生活质量,而且降低减重手术的效果。Bariplastic surgery于2004年由美国O’Connell JB提出,术后再接受塑形手术以去除包括过多皮肤在内的多余组织,可以达到显著改善外观、增加自信、更好地提高减重效果,进而达到提高生活质量的目的。



顾岩教授在做学术报告

顾岩教授查询美国资料显示:减重术后有塑形手术意愿的病人约占75%,但只有21%的人会最终接受手术,美国接受塑形手术的病人约5万人/年。塑形手术的指征与手术时间根据不同国家和地区制订了各自的标准,但吸烟及伴社会心理障碍病人不建议接受手术。塑形手术前包括多学科的联合评估,术前准备不仅包括纠正各种营养不良的状况,也包括心里疏导、行为学指导以及心理支持。

塑形手术及二期塑形的部位主要有6处,既可分期进行也可同期进行,据统计,腹壁塑形术数量最多,约占总数的60%。另据塑形手术长期的随访显示,患者术后生活质量和功能状态会得到明显提升,在对减重术后9年随访研究表明,90%以上的病人对术后体重的维持及塑形手术效果满意。
 


顾岩教授与参会专家进行问答互动

顾岩教授也强调了塑形手术的并发症,就切口相关并发症的发生率来看,其中不吸烟患者的发生率为46%,吸烟患者的发生率可达69%。另外病人术前BMI和塑形手术时BMI也与发生率密切相关。减重术后行塑形术病人比其他病人更易出现切口裂开、脂肪坏死、静脉血栓和皮肤坏死。

近年来,减重代谢手术治疗肥胖症和糖尿病取得了可喜的进步。然而,由于地区水平差异乃至不同学科治疗理念的不同,减重和代谢外科在我国各地的发展水平参差不齐。通过此次会议的举办,使得参会的专家交流了经验、年轻医生学习了丰富的知识,在今后的工作中将这些经验知识更好的应用于临床,服务于患者。

个人简介:

 

顾岩,男,博士、博士后,上海交通大学教授、主任医师、博士研究生导师。1986年大学本科毕业,1999年上海医科大学获临床医学博士学位,1999-2001年完成博士后工作站工作,2004-2005年美国加州大学洛杉矶分校(UCLA)医学中心访问学者。现任上海交通大学医学院附属第九人民医院普外科主任、外科教研室主任,外科住院医师规范化培训基地与普外科专科医师培训基地主任,上海交通大学疝与腹壁外科疾病诊治中心主任。

顾岩教授长期工作在普外科医教研一线,临床上主要从事疝与腹壁外科、减重与代谢外科及胃肠道肿瘤外科、软组织肿瘤外科的诊断与治疗工作。目前担任中华医学会疝与腹壁外科学组委员、中国医师协会疝与腹壁外科专委会常委、中国医师协会肥胖和糖尿病委员会委员及上海市医学会外科、普外科专委会委员、上海市医学会疝与腹壁外科学组副组长、上海市医师协会普外科医师分会委员、上海市抗癌协会胃肠道肿瘤专委会委员等多项学术工作。是包括《中华疝与腹壁外科杂志》、《中华肥胖与代谢病杂志》、《中华胃食管反流病杂志》等多家杂志的常务编委、编委。承担包括多项国家自然科学基金在内的国家与省市级科研项目10余项,发表论著160余篇,其中SCI论著40余篇,主编《实用腹壁外科学》、《实用代谢和减重外科学》《结直肠癌早期诊断与治疗》等专著4部,参编专著6部,培养硕士与博士研究生20余名,作为主要完成人之一曾获上海市科技进步一等奖。

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    2017-02-10 chg121
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1710879, encodeId=1bae1e108795e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Oct 11 17:07:00 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877679, encodeId=3f9118e76795c, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri Feb 10 05:07:00 CST 2017, time=2017-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021529, encodeId=f76a2021529d9, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Sun Jul 31 01:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132094, encodeId=be0e132094c3, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:24:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128493, encodeId=b6511284932a, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:38:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125774, encodeId=4bd3125e7479, content=感谢分享,好厉害的角色, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 21:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-21 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1710879, encodeId=1bae1e108795e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Oct 11 17:07:00 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877679, encodeId=3f9118e76795c, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri Feb 10 05:07:00 CST 2017, time=2017-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021529, encodeId=f76a2021529d9, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Sun Jul 31 01:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132094, encodeId=be0e132094c3, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:24:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128493, encodeId=b6511284932a, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:38:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125774, encodeId=4bd3125e7479, content=感谢分享,好厉害的角色, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 21:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-16 1e10c84am36(暂无匿称)

    不错哦,会学到很多

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1710879, encodeId=1bae1e108795e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Oct 11 17:07:00 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877679, encodeId=3f9118e76795c, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Fri Feb 10 05:07:00 CST 2017, time=2017-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021529, encodeId=f76a2021529d9, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Sun Jul 31 01:07:00 CST 2016, time=2016-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132094, encodeId=be0e132094c3, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:24:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128493, encodeId=b6511284932a, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 09:38:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=125774, encodeId=4bd3125e7479, content=感谢分享,好厉害的角色, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Tue Sep 13 21:58:00 CST 2016, time=2016-09-13, status=1, ipAttribution=)]
    2016-09-13 舒心和人

    感谢分享,好厉害的角色

    0