Department of Surgery, Hadassah Hebrew University Medical Center, Israel.
Curr Opin Clin Nutr Metab Care. 2011 May;14(3):286-90. doi: 10.1097/MCO.0b013e3283453635.
Bariatric surgery is gaining acceptance as an effective and well tolerated treatment of morbid obesity in adults yet experience in obese children is still lacking. The purpose of this review is to highlight recent findings in this exciting field and identify the knowledge gaps.
One randomized controlled trial and several case series have been published in the last 2 years regarding bariatric surgery for obese adolescents. These studies demonstrate relative safety along with significant weight loss. In addition, the vast majority of obesity-related comorbidities are resolved following these procedures. Adverse psychological effects of these procedures are probably more common than those in adults and need to be addressed.
These publications indicate that bariatric surgical procedures, mainly gastric banding and gastric bypass, when performed on the right patients by skilled surgeons along with the appropriate ancillary staff, show positive metabolic effects and are well tolerated. Precise patient selection criteria, choice of the procedure and the extent of the multidisciplinary preoperative and postoperative care, are yet to be defined.
减重手术作为一种有效且耐受性良好的病态肥胖成人治疗方法，已逐渐被认可，但在肥胖儿童中的应用经验仍有限。本综述的目的是强调这一令人兴奋领域的最新发现，并确定知识空白。
过去 2 年，已有一项随机对照试验和几项病例系列研究发表了关于肥胖青少年减重手术的内容。这些研究表明，该手术相对安全，同时可显著减重。此外，绝大多数肥胖相关的合并症在这些手术后都得到了缓解。这些手术的不良心理影响可能比成人更常见，需要加以解决。
这些出版物表明，当由熟练的外科医生在适当的辅助人员的配合下，对合适的患者施行减重手术（主要是胃带术和胃旁路术）时，可产生积极的代谢效果，且具有良好的耐受性。但仍需确定精确的患者选择标准、手术选择以及多学科术前和术后护理的范围。
