Department of Surgery, Madigan Army Medical Center, Tacoma, WA.
J Pediatr Surg. 2013 Dec;48(12):2401-7. doi: 10.1016/j.jpedsurg.2013.08.015.
Morbid obesity continues to be a significant problem within the United States, as overweight/obesity rates are nearing 33%. Bariatric surgery has had success in treating obesity in adults and is becoming a viable treatment option for obese adolescents.
We studied 1615 inpatient admissions for children ≤20 years of age undergoing a bariatric procedure for morbid obesity in 2009 using the Kids' Inpatient Database (KID). Patients had a principal diagnosis of obesity and a bariatric procedure listed as one of their first 5 procedures. Procedures (open gastric bypass, laparoscopic gastric bypass, sleeve gastrectomy, laparoscopic gastroplasty, and laparoscopic gastric band) and complications were defined by ICD-9 codes.
There were 90 open gastric bypasses, 906 laparoscopic gastric bypasses, 150 sleeve gastrectomies, 18 laparoscopic gastroplasties, and 445 laparoscopic gastric bandings. The length of stay for each procedure was 2.44, 2.20, 2.33, 1.10, and 1.02 days, respectively (P<0.001). The complication rates were 3.3%, 3.5%, 0.7%, 0.0%, 0.2%, respectively (P=0.004).
Bariatric surgery is an increasingly utilized option for the treatment of morbid obesity among adolescents. The procedures can be performed safely as evidenced by low complication rates. Additional long-term follow-up is necessary.
病态肥胖在美国仍然是一个严重的问题，超重/肥胖率接近 33%。减重手术在治疗成人肥胖方面已取得成功，并且正在成为肥胖青少年的一种可行治疗选择。
我们使用 Kids' Inpatient Database (KID) 研究了 2009 年 1615 名因病态肥胖接受减重手术的≤20 岁住院患者。患者的主要诊断为肥胖症，且减重手术被列为其前 5 项手术之一。手术（开放式胃旁路手术、腹腔镜胃旁路手术、袖状胃切除术、腹腔镜胃成形术和腹腔镜胃带术）和并发症通过 ICD-9 代码定义。
有 90 例开放式胃旁路手术、906 例腹腔镜胃旁路手术、150 例袖状胃切除术、18 例腹腔镜胃成形术和 445 例腹腔镜胃带术。每种手术的住院时间分别为 2.44、2.20、2.33、1.10 和 1.02 天（P<0.001）。并发症发生率分别为 3.3%、3.5%、0.7%、0.0%、0.2%（P=0.004）。
减重手术是治疗青少年病态肥胖症的一种越来越被广泛采用的选择。这些手术可以安全进行，并发症发生率低。需要进行更多的长期随访。
