van Mil Stefanie Ramona, Biter Laser Ulas, Grotenhuis Brechtje Aleid, Zengerink Johannes Franciscus, Mannaerts Guido Hein Huib
Department of Surgery, Sint Franciscus Vlietland Gasthuis, Rotterdam, The Netherlands.
Department of Surgery, Erasmus MC, Rotterdam, The Netherlands.
Eur J Pediatr Surg. 2016 Dec;26(6):487-493. doi: 10.1055/s-0035-1570104. Epub 2016 Jan 8.
Interest in bariatric surgery in adolescents is increasing, because adolescent obesity equals increased health risks in adult life. To define the preferred procedure in adolescents, this study compares outcomes of LSG and LRYGB in late adolescents in our center. Data on baseline characteristics, operative details, and follow-up were collected retrospectively in all patients (age 18-20 years) who underwent LSG or LRYGB in our clinic. Outcomes were analyzed using nonparametric tests. Total 65 adolescents (54 females; median age 19 years) were included, 45 patients underwent LSG, and 20 underwent LRYGB.Significant differences in %EWL were observed at 2-year follow-up; 81.0% in LRYGB ( = 11) versus 96.8% in LSG ( = 23), = 0.007. No differences were observed in postoperative mortality, complication rate, and resolution of comorbidities between both procedures. LSG showed significant better results than LRYGB in terms of %EWL after 2 years in this selected group of late adolescents. Considering these results in LSG patients and the theoretical advantages of LSG (normal diet options, preservation of an intact GI-tract, less vitamin disturbances, and better quality of life), LSG may be an appropriate bariatric technique to perform in morbidly obese adolescents.
青少年对减肥手术的兴趣日益增加，因为青少年肥胖意味着成年后健康风险增加。为了确定青少年首选的手术方式，本研究比较了我们中心晚期青少年患者接受袖状胃切除术（LSG）和腹腔镜Roux-en-Y胃旁路术（LRYGB）的效果。回顾性收集了在我们诊所接受LSG或LRYGB手术的所有患者（年龄18 - 20岁）的基线特征、手术细节和随访数据。采用非参数检验分析结果。共纳入65名青少年（54名女性；中位年龄19岁），45例患者接受了LSG，20例接受了LRYGB。在2年随访时观察到的额外体重减轻百分比（%EWL）有显著差异；LRYGB组为81.0%（n = 11），而LSG组为96.8%（n = 23），P = 0.007。两种手术在术后死亡率、并发症发生率和合并症缓解方面均未观察到差异。在这组选定的晚期青少年中，LSG在2年后的%EWL方面显示出比LRYGB显著更好的结果。考虑到LSG患者的这些结果以及LSG的理论优势（正常饮食选择、保留完整的胃肠道、较少的维生素紊乱和更好的生活质量），LSG可能是对病态肥胖青少年进行减肥手术的合适技术。
