Dufour F, Champault G
Service de chirurgie digestive, hôpital Jean-Verdier, université Paris XIII, UFR Leonard-de-Vinci, avenue du 14-Juillet, 93143 Bondy, France.
J Chir (Paris). 2009 Feb;146(1):24-9. doi: 10.1016/j.jchir.2009.02.011. Epub 2009 Apr 22.
Current recommendations for bariatric surgery are limited to patients older than 18 years. Two studies in 2007 showed that bariatric surgery improves survival in adults. Medical management of severe obesity in adolescents is all too often ineffective. For these reasons, early surgical intervention for adolescents with morbid obesity may be expected to prevent or avoid comorbidities, decrease mortality, and improve the quality of life. Several studies have demonstrated the feasibility of adolescent bariatric surgery with morbidity comparable to that seen in adult series. The earlier the surgery, the better the result in terms of prevention or reversal of comorbid conditions. In the USA, a consensus definition of adolescents eligible for bariatric surgery specifies attainment of Tanner Stage IV of sexual maturity and achievement of 95% of axial growth. Just as in adults, bariatric surgery in adolescents requires prolonged follow-up; it is important that such surgery be performed in centers specialized in adult bariatric surgery having the necessary multidisciplinary structure.
目前关于减肥手术的建议仅限于18岁以上的患者。2007年的两项研究表明，减肥手术可提高成年人的生存率。青少年严重肥胖的药物治疗往往无效。基于这些原因，对患有病态肥胖的青少年进行早期手术干预有望预防或避免并发症、降低死亡率并提高生活质量。多项研究已证明青少年减肥手术的可行性，其发病率与成人系列相当。手术越早，在预防或逆转合并症方面的效果越好。在美国，符合减肥手术条件的青少年的共识定义明确为达到性成熟的坦纳四期以及实现95%的轴向生长。与成年人一样，青少年减肥手术需要长期随访；重要的是，此类手术应在具备必要多学科结构的成人减肥手术专业中心进行。
