Angrisani L, Favretti F, Furbetta F, Paganelli M, Basso N, Doldi S B, Iuppa A, Lucchese M, Lattuada E, Lesti G, Capizzi F D, Giardiello C, Di Lorenzo N, Veneziani A, Alkilani M, Puglisi F, Gardinazzi A, Cascardo A, Borrelli V, Lorenzo M
Italian Collaborative Study Group for Lap-Band System, Naples, Italy.
Surgery. 2005 Nov;138(5):877-81. doi: 10.1016/j.surg.2005.07.012.
Little is known about obesity surgery in young and adolescent patients. The aim of this study is to evaluate results of laparoscopic adjustable gastric banding in obese teenagers.
Patients < or = 19 years old selected from the database of the Italian Collaborative Study Group for Lap-Band were analyzed according to mortality, comorbidities, laparotomic conversion, intra- and postoperative complications, body mass index (BMI), and % excess weight loss (EWL) at different times of follow-up. Data were expressed as mean +/- SD.
Fifty-eight (1.5%) of 3813 patients who underwent operation with the Lap-Band System were < or = 19 years old: 47F/11M; mean age, 17.96 +/- 0.99 years (range, 15-19); mean BMI, 46.1 +/- 6.31 Kg/m2 (range, 34.9 - 69.25); mean % excess weight, 86.4 +/- 27.1 (range, 34 - 226.53). Sixteen (27.5%) of the 58 patients were superobese (BMI > or = 50). In 27/58 (46.5%) patients, 1 or more comorbidities were diagnosed. Mortality was absent. Laparotomic conversion was necessary in 1 patient with gastric perforation on the anterior wall. Overall postoperative complications occurred in 6/58 (10.3%). The band was removed in 6/58 (10.3%) patients for gastric erosion (3 patients), psychologic, intolerance (2 patients), and in the remaining patient was converted 2 years after surgery (BMI 31) to gastric bypass or gastric pouch dilatation. Patient follow-up at 1, 3, 5, and 7 years was 48/52 (92.3%), 37/42 (88.1%), 25/33 (75.7%), and 10/10, respectively. At these times, mean BMI was 35.9 +/- 8.4, 37.8 +/- 11.27, 34.9 +/- 12.2, and 29.7 +/- 5.2 Kg/m2. Mean %EWL at the same time was 45.6 +/- 29.6, 39.7 +/- 29.8, 43.7 +/- 38.1, and 55.6 +/- 29.2. Five/25 (20%) patients had < or = 25% EWL at 5 years follow-up, while none of the 10 patients subject to follow-up at 7 years had < or = 25% EWL.
Lap-Band System is an interesting option for teenagers suffering obesity and its related comorbidities, which deserves further investigation.
关于年轻及青少年患者的肥胖症手术，人们了解甚少。本研究旨在评估腹腔镜可调节胃束带术在肥胖青少年中的效果。
从意大利腹腔镜胃束带术协作研究组数据库中选取年龄≤19岁的患者，根据死亡率、合并症、开腹手术转换情况、术中和术后并发症、体重指数（BMI）以及不同随访时间的超重体重减轻百分比（EWL）进行分析。数据以均值±标准差表示。
3813例行腹腔镜胃束带术系统手术的患者中，58例（1.5%）年龄≤19岁：47例女性/11例男性；平均年龄17.96±0.99岁（范围15 - 19岁）；平均BMI为46.1±6.31kg/m²（范围34.9 - 69.25）；平均超重百分比为86.4±27.1（范围34 - 226.53）。58例患者中有16例（27.5%）为超级肥胖（BMI≥50）。27/58例（46.5%）患者被诊断出一种或多种合并症。无死亡病例。1例前壁胃穿孔患者需转为开腹手术。总体术后并发症发生率为6/58例（10.3%）。6/58例（10.3%）患者因胃糜烂（3例）、心理不耐受（2例）而取出束带，其余1例患者在术后2年（BMI 31）转为胃旁路手术或胃囊扩张术。1年、3年、5年和7年的患者随访率分别为48/52例（92.3%）、37/42例（88.1%）、25/33例（75.7%）和10/10例。在这些时间点，平均BMI分别为35.9±8.4、37.8±11.27、34.9±12.2和29.7±5.2kg/m²。同期平均EWL分别为45.6±29.6、39.7±29.8、43.7±38.1和55.6±29.2。5/25例（20%）患者在5年随访时EWL≤25%，而在7年随访的10例患者中无一例EWL≤25%。
腹腔镜胃束带术系统对于患有肥胖症及其相关合并症的青少年是一个有吸引力的选择，值得进一步研究。
