Schmitt Françoise, Riquin Elise, Beaumesnil Marion, Dinomais Mickaël, Topart Philippe, Weil Dominique, Malka Jean, Coutant Régis, Podevin Guillaume, Bouhours-Nouet Natacha
Pediatric Surgery Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France.
Pediatric Psychiatry Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France.
J Pediatr Surg. 2016 Mar;51(3):403-8. doi: 10.1016/j.jpedsurg.2015.08.057. Epub 2015 Sep 14.
BACKGROUND/PURPOSE: Obesity now affects 3%-4% of the pediatric population and contributes to the increase in cardiac mortality in adulthood. Bariatric surgery is the best treatment for weight loss and the obesity-associated comorbidities in adults. We report here our experience of laparoscopic adjustable gastric banding (LAGB) in adolescents.
The medical charts of the first 16 patients operated on in our center were reviewed. Data were compiled concerning weight loss, physical and biological comorbidities, health-related quality of life (QOL) and surgical complications before surgery and during 24months of follow-up.
The maximal pre-operative median body mass index was 43.0kg·m(-2), decreasing to 33.0kg·m(-2) at 2years post-LAGB, which corresponded to a 49.2% excess body weight loss (p<0.001). Most comorbidities (glucose intolerance, hypertension and sleep apnea) resolved within the first year post-LAGB and QOL was improved on the PedsQL™ scales. No severe surgical complications were noted, with only three re-interventions for device failure (2) or band removal (1).
LAGB is well tolerated in adolescents and shows a beneficial impact on weight loss and obesity-related comorbidities. Associated with global management, it may have a positive impact on patients' QOL and social and psychological status.
背景/目的：肥胖目前影响3%-4%的儿童人群，并导致成年人心脏病死亡率上升。减肥手术是治疗成人肥胖及肥胖相关合并症的最佳方法。我们在此报告我们在青少年中进行腹腔镜可调节胃束带术（LAGB）的经验。
回顾了我们中心首批接受手术的16例患者的病历。收集了术前及术后24个月随访期间有关体重减轻、身体和生物学合并症、健康相关生活质量（QOL）及手术并发症的数据。
术前最大中位体重指数为43.0kg·m⁻²，LAGB术后2年降至33.0kg·m⁻²，相当于超重体重减轻了49.2%（p<0.001）。大多数合并症（糖耐量异常、高血压和睡眠呼吸暂停）在LAGB术后第一年内得到缓解，并且在儿童生活质量量表（PedsQL™）上生活质量得到改善。未发现严重手术并发症，仅3例因器械故障（2例）或束带移除（1例）进行了再次干预。
青少年对LAGB耐受性良好，并且对体重减轻及肥胖相关合并症有有益影响。与整体管理相结合，它可能对患者的生活质量以及社会和心理状态产生积极影响。
