Division of Pediatric Surgery, Children's National Medical Center, Washington, DC, USA.
Surgery. 2012 Aug;152(2):212-7. doi: 10.1016/j.surg.2012.05.010.
Obesity has been identified as one of the most important public health concerns in both children and adolescents. Unfortunately, even the most comprehensive and aggressive multidisciplinary weight management programs have shown only modest weight loss results. There has been increasing enthusiasm for bariatric surgery for adolescent patients with morbid obesity. Because of the relatively high morbidity and mortality associated with gastric bypass surgery, we have begun to explore laparoscopic sleeve gastrectomy as an alternative. We hypothesized that it would be a safe and effective short-term strategy.
We have prospectively collected data from all patients undergoing bariatric surgery at our institution since the inception of our adolescent weight loss surgery program in January 2010. Baseline data collected included age, gender, race/ethnicity, height, weight, body mass index, and comorbid conditions. Postoperative data collected included the type of operation, length of stay, operative morbidity, the need for reoperation, and percent excess weight loss and body mass index at 3-month intervals.
Twenty-three patients have undergone laparoscopic sleeve gastrectomy at our institution since January 2010. Of these, 18 were female and 5 were male. The mean age was 17.3 ± 1.5 years of age. The mean preoperative weight was 149 ± 30 kg with a body mass index of 52 ± 9 kg/m(2). There were no intraoperative complications, and the only postoperative complication has been pancreatitis in 1 patient. The mean length of stay was 2.2 ± 1.1 days. The mean follow-up was 10.9 ± 7.4 months. The percent excess weight loss at 3 months, 6 months, and 1 year postoperatively was 32%, 38%, and 40%, respectively, in those who had reached these time points.
Laparoscopic sleeve gastrectomy is a safe operation for adolescent patients with morbid obesity and represents an effective early treatment strategy with approximately 40% excess weight loss at 6 months and 1 year of follow-up. Because of the minimal morbidity associated with laparoscopic sleeve gastrectomy, it may be the optimal non-device surgical option for this select group of adolescent patients.
肥胖已被确定为儿童和青少年最重要的公共卫生问题之一。不幸的是，即使是最全面和积极的多学科体重管理计划也仅显示出适度的体重减轻效果。对于病态肥胖的青少年患者，减重手术的热情日益高涨。由于胃旁路手术相关的发病率和死亡率较高，我们开始探索腹腔镜袖状胃切除术作为替代方法。我们假设它将是一种安全有效的短期策略。
自 2010 年 1 月我们的青少年减肥手术计划启动以来，我们一直在前瞻性地从我们机构接受减肥手术的所有患者中收集数据。收集的基线数据包括年龄、性别、种族/民族、身高、体重、体重指数和合并症。收集的术后数据包括手术类型、住院时间、手术发病率、再次手术的需要以及 3 个月间隔时的超重体重减轻百分比和体重指数。
自 2010 年 1 月以来，我们机构共进行了 23 例腹腔镜袖状胃切除术，其中 18 例为女性，5 例为男性。平均年龄为 17.3 ± 1.5 岁。术前平均体重为 149 ± 30kg，体重指数为 52 ± 9kg/m2。无术中并发症，仅 1 例术后发生胰腺炎。平均住院时间为 2.2 ± 1.1 天。平均随访时间为 10.9 ± 7.4 个月。达到这些时间点的患者，术后 3 个月、6 个月和 1 年的超重体重减轻百分比分别为 32%、38%和 40%。
腹腔镜袖状胃切除术是病态肥胖青少年患者的安全手术，代表了一种有效的早期治疗策略，术后 6 个月和 1 年的超重体重减轻百分比分别约为 40%。由于腹腔镜袖状胃切除术相关的发病率较低，因此它可能是该特定青少年患者群体的最佳非器械手术选择。
