General Surgery, University of Nebraska Medical Center, Omaha, NE 985126, USA.
Surg Endosc. 2012 Nov;26(11):3077-81. doi: 10.1007/s00464-012-2318-0. Epub 2012 May 12.
With increasing childhood obesity, adolescent bariatric surgery has been increasingly performed. We used a national database to analyze current trends in laparoscopic bariatric surgery in the adolescent population and related short-term outcomes.
Discharge data from the University Health System Consortium (UHC) database was accessed using International Classification of Disease codes during a 36 month period. UHC is an alliance of more than 110 academic medical centers and nearly 250 affiliate hospitals. All adolescent patients between 13 and 18 years of age, with the assorted diagnoses of obesity, who underwent laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) were evaluated. The main outcome measures analyzed were morbidity, mortality, length of hospital stay (LOS), overall cost, intensive care unit (ICU) admission rate, and readmission rate. These outcomes were compared to those of adult bariatric surgery.
Adolescent laparoscopic bariatric surgery was performed on 329 patients. At the same time, 49,519 adult bariatric surgeries were performed. One hundred thirty-six adolescent patients underwent LAGB, 47 had SG, and 146 patients underwent LRYGB. LAGB has shown a decreasing trend (n = 68, 34, and 34), while SG has shown an increasing trend (n = 8, 15, and 24) over the study years. LRYGB remained stable (n = 44, 60, and 42) throughout the study period. The individual and summative morbidity and mortality rates for these procedures were zero. Compared to adult bariatric surgery, 30 day in-hospital morbidity (0 vs. 2.2 %, p < 0.02), the LOS (1.99 ± 1.37 vs. 2.38 ± 3.19, p < 0.03), and 30 day readmission rate (0.30 vs. 2.02 %, p < 0.05) are significantly better for adolescent bariatric surgery, while the ICU admission rate (9.78 vs. 6.30 %, p < 0.02) is higher and overall cost ($9,375 ± 6,452 vs. $9,600 ± 8,016, p = 0.61) is comparable.
Trends in adolescent laparoscopic bariatric surgery reveal the increased use of sleeve gastrectomy and adjustable gastric banding falling out of favor.
随着儿童肥胖症的增加，青少年减重手术的应用也越来越多。我们使用国家数据库分析了青少年人群中腹腔镜减重手术的当前趋势及相关短期结果。
在 36 个月的时间里，通过国际疾病分类代码从 UHC 数据库中获取了出院数据。UHC 是一个由 110 多个学术医疗中心和近 250 家附属医院组成的联盟。所有年龄在 13 至 18 岁之间、有肥胖症诊断的青少年患者，接受了腹腔镜可调胃束带术（LAGB）、袖状胃切除术（SG）和腹腔镜 Roux-en-Y 胃旁路术（LRYGB）。主要观察指标为发病率、死亡率、住院时间（LOS）、总费用、重症监护病房（ICU）入住率和再入院率。这些结果与成人减重手术进行了比较。
对 329 名青少年进行了腹腔镜减重手术。与此同时，对 49519 例成人进行了减重手术。136 名青少年接受了 LAGB，47 名接受了 SG，146 名接受了 LRYGB。LAGB 的数量呈下降趋势（n=68、34 和 34），而 SG 的数量呈上升趋势（n=8、15 和 24）。在整个研究期间，LRYGB 保持稳定（n=44、60 和 42）。这些手术的个体和综合发病率和死亡率均为零。与成人减重手术相比，青少年减重手术的 30 天住院发病率（0 比 2.2%，p<0.02）、住院时间（1.99±1.37 比 2.38±3.19，p<0.03）和 30 天再入院率（0.30 比 2.02%，p<0.05）明显更好，而 ICU 入住率（9.78 比 6.30%，p<0.02）更高，总费用（9375±6452 比 9600±8016，p=0.61）相当。
青少年腹腔镜减重手术的趋势表明，袖状胃切除术和可调胃束带术的使用越来越多，而这两种术式的应用正在减少。
