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.
Schlüsselwörter
monogenetische Adipositas - Adipositaschirurgie - Prader-Willi-Syndrom
Key words
obesity genetic - obesity surgery - Prader-Willi-Syndrome
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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