Landau Zohar, Karplus Gideon, Hanukoglu Aaron, Abiri Shirli, Levy Anat, Serour Francis
Pediatric Endocrinology Service, E. Wolfson Medical Center, Holon, Israel.
Harefuah. 2011 Oct;150(10):765-8, 816, 815.
Morbid obesity has become a significant health problem for the pediatric population. The medical impact of obesity in youth is determinant. Conservative methods for weight loss are disappointing and therefore, bariatric surgery should be considered.
To present the experience of laparoscopic sleeve gastrectomy in adolescents with morbid obesity, treated by the pediatric multi-disciplinary obesity clinic.
All patients (n=7, all female) participated in a weight loss program for at least 6 months without success. At referral, the mean age was 16.2 years (range 13.8 - 18 years), mean body mass index (BMI in kg/m2) was 44.4 (range 38.9-55.2). All suffered from various co-morbidities of obesity: type 2 diabetes, insulin treated (n=1), hypertension (n=5), fatty liver (n=2), obstructive sleep apnea (n=2) and pseudotumor cerebri (n=1).
There were no intra- or postoperative complications. After a mean follow-up of 15.1 months (range 5-25 months), all patients but one had reduced BMI (mean BMI of 32.55). In all subjects who lost weight, remission or improvement of the co-morbidities was noted.
In this study, with a mean follow-up of 15.1 months, LSG was proven to be a safe and effective option of bariatric surgery in adolescents, resulting in a significant weight loss and remission or improvement of co-morbidities. We suggest that LSG might be considered as a single intervention for morbid obesity in adolescents. Long-term studies are needed to evaluate the efficacy of LSG and other bariatric surgeries in adolescents.
病态肥胖已成为儿科人群的一个重大健康问题。肥胖对青少年的医学影响是决定性的。保守的减肥方法效果不佳，因此应考虑进行减肥手术。
介绍小儿多学科肥胖诊所治疗青少年病态肥胖的腹腔镜袖状胃切除术经验。
所有患者（n = 7，均为女性）参加了至少6个月的减肥计划但未成功。转诊时，平均年龄为16.2岁（范围13.8 - 18岁），平均体重指数（BMI，单位：kg/m²）为44.4（范围38.9 - 55.2）。所有患者都患有各种肥胖相关合并症：2型糖尿病，接受胰岛素治疗（n = 1），高血压（n = 5），脂肪肝（n = 2），阻塞性睡眠呼吸暂停（n = 2）和假性脑瘤（n = 1）。
无术中或术后并发症。平均随访15.1个月（范围5 - 25个月）后，除1例患者外，所有患者的BMI均降低（平均BMI为32.55）。在所有体重减轻的受试者中，均观察到合并症缓解或改善。
在本研究中，平均随访15.1个月，腹腔镜袖状胃切除术被证明是青少年减肥手术的一种安全有效的选择，可显著减轻体重，并缓解或改善合并症。我们建议腹腔镜袖状胃切除术可被视为青少年病态肥胖的单一干预措施。需要进行长期研究以评估腹腔镜袖状胃切除术和其他减肥手术在青少年中的疗效。
