Paulus Givan F, de Vaan Loes E G, Verdam Froukje J, Bouvy Nicole D, Ambergen Ton A W, van Heurn L W Ernest
Department of Surgery, Maastricht University Medical Center, and Nutrition and Toxicology Research Institute (NUTRIM), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands,
Obes Surg. 2015 May;25(5):860-78. doi: 10.1007/s11695-015-1581-2.
Pubmed, Embase, and Cochrane were systematically reviewed for available evidence on bariatric surgery in adolescents. Thirty-seven included studies evaluated the effect of laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), or laparoscopic sleeve gastrectomy (LSG) in patients ≤18 years old. Fifteen of 37 studies were prospective, including one RCT. Mean body mass index (BMI) loss after LAGB was 11.6 kg/m(2) (95% CI 9.8-13.4), versus 16.6 kg/m(2) (95% CI 13.4-19.8) after RYGB and 14.1 kg/m(2) (95% CI 10.8-17.5) after LSG. Two unrelated deaths were reported after 495 RYGB procedures. All three bariatric procedures result in substantial weight loss and improvement of comorbidity with an acceptable complication rate, indicating that surgical intervention is applicable in appropriately selected morbidly obese adolescents.
我们系统检索了PubMed、Embase和Cochrane数据库,以获取有关青少年减肥手术的现有证据。纳入的37项研究评估了腹腔镜可调节胃束带术(LAGB)、Roux-en-Y胃旁路术(RYGB)或腹腔镜袖状胃切除术(LSG)对18岁及以下患者的影响。37项研究中有15项为前瞻性研究,其中包括1项随机对照试验。LAGB术后平均体重指数(BMI)下降11.6kg/m²(95%CI 9.8-13.4),RYGB术后为16.6kg/m²(95%CI 13.4-19.8),LSG术后为14.1kg/m²(95%CI 10.8-17.5)。495例RYGB手术报告了2例非相关性死亡。所有三种减肥手术均能显著减轻体重并改善合并症,并发症发生率可接受,这表明手术干预适用于经过适当选择的病态肥胖青少年。