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腹腔镜胃旁路术治疗青少年患者:长期结果。

Laparoscopic gastric bypass for the adolescent patient: long-term results.

机构信息

University of California at San Diego, San Diego, CA 92103, USA.

出版信息

Obes Surg. 2012 Sep;22(9):1445-9. doi: 10.1007/s11695-012-0670-8.

Abstract

BACKGROUND

Obesity is a major public health problem in the developed world. The National Survey of Children's Health 2003 estimated around 17 million children in the USA to be overweight, making this a significantly alarming disease in the young population. Findings from the Third National Health and Nutrition Examination Survey demonstrated at least 30 % of overweight adolescents to be suffering from the metabolic syndrome. Combined metabolic and restrictive bariatric operations have been shown to improve or resolve these various comorbidities, and surgical therapy is recommended as a part of a multidisciplinary approach to the treatment of morbid obesity in adults. Data in the adolescent population are sparse.

METHODS

This is a retrospective, descriptive study of prospectively collected data over 10 years. Twenty-five adolescents between the ages of 14 and 18 years underwent laparoscopic Roux-en-Y gastric bypass (RYGBP) using a standard technique by a single surgeon with follow-up of at least 5 years.

RESULTS

Twenty of the 25 patients were available for follow-up from 5 to 10 years after their operation. Average BMI preop/postop was 45.7/28.6 kg/m(2). Average percentage of excess body weight loss was 77.7 %. Average BMI change was 17.1.

CONCLUSION

Our long-term data demonstrate that laparoscopic RYGBP is a safe and effective operation for morbidly obese adolescents, in the proper setting. We advocate that surgical intervention be recommended for this population using the same NIH guidelines used for adults.

摘要

背景

肥胖是发达国家的一个主要公共卫生问题。2003 年的《全国儿童健康调查》估计,美国约有 1700 万名儿童超重,这使得这种疾病在年轻人群中非常令人担忧。第三次国家健康和营养检查调查的结果表明,至少有 30%的超重青少年患有代谢综合征。联合代谢和限制性减肥手术已被证明可以改善或解决这些各种合并症,并且手术治疗被推荐作为治疗成人病态肥胖的多学科方法的一部分。青少年人群的数据很少。

方法

这是一项对 10 年来前瞻性收集数据的回顾性描述性研究。25 名年龄在 14 至 18 岁之间的青少年接受了腹腔镜 Roux-en-Y 胃旁路术(RYGBP),由一位外科医生采用标准技术进行,至少随访 5 年。

结果

25 名患者中有 20 名在手术后 5 至 10 年可进行随访。术前/术后平均 BMI 为 45.7/28.6kg/m²。平均超重体重减轻百分比为 77.7%。平均 BMI 变化为 17.1。

结论

我们的长期数据表明,在适当的情况下,腹腔镜 RYGBP 是治疗病态肥胖青少年的一种安全有效的手术。我们主张使用与成人相同的 NIH 指南,为这一人群推荐手术干预。

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