고도비만 환자의 수술적 치료 = A Review of Bariatric Surgery Procedures and Outcomes

국문 초록 (Abstract)

전세계적으로 비만이 심각하게 문제가 되고 있고, 비만에 대한 많은 연구가 이루어지고 국가적으로 치료와 예방에 관심을 쏟고 있지만, 비만인구는 지속적으로 증가하고 있다. 비만치료 방법에는 운동요법, 상담, 약물요법 등 비수술적 치료법과 수술이 있다. 이중 동반질환이 문제를 일으키고 삶에 질에 문제가 생기는 환자들에게 효과적인 치료법은 현재까지는 수술이다. 효과, 합병증, 장기 관찰결과 등에 대한 연구를 통해 현재 사용되는 대표적인 수술법은 위밴드술, 위 우회술이다. 더욱이 이 수술은 복강경수술로 가능하게 되어 수술과 관련된 합병증은 더욱 줄어들고, 효과는 개복하였을 때와 대등한 결과를 얻고 있다. 비만치료의 목적은 체중감소에 있지만, 이를 통해 많은 동반질환이 개선되고, 이데 따라 삶의 질이 정상인에 가깝게 개선되는 결과를 보이고 있다.

비만수술은 술기나 기구의 발달로 점차로 안전해지고 장기 합병증의 예방과 치료에 대한 지식도 늘어나 환자관리 방법도 적절하고 다양하게 발전하고 있다. 게다가 수술을 하지 않았을 때의 사망률과 수술 후 사망률을 비교해도 수술을 하는 것이 절대적으로 유리하다.

우리나라에서 비만수술에 대해서는 아직까지 일반인과 의사들에게 부정적이다. 한국에서 비만수술은 아직까지 흔치 않은 수술이고, 따라서 수술성적을 논하기엔 이르지만, 서구의 상황과 차이가 그리 크지 않을 것으로 예상한다. 우리나라의 비만상황에 대한 정확한 통계가 아직 없어서 수술의 적응증을 말할 수는 없지만 서구에 비해 낮은 BMI의 환자가 대상이 되리라는 예상은 할 수 있을 것이고, 적응증이 되는 환자에서 수술적 치료를 해야 할 것이다.

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