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对肥胖青少年患者(<18岁)进行Roux-en-Y胃旁路手术的长期(7年)随访

Long-Term (7 Years) Follow-Up of Roux-en-Y Gastric Bypass on Obese Adolescent Patients (<18 Years).

作者信息

Vilallonga Ramon, Himpens Jacques, van de Vrande Simon

机构信息

Division of Bariatric Surgery, AZ St-Blasius, Dendermonde, Belgium.

出版信息

Obes Facts. 2016;9(2):91-100. doi: 10.1159/000442758. Epub 2016 Apr 2.

Abstract

BACKGROUND

Few data are available about obesity surgery in adolescent patients.

OBJECTIVE

To assess long-term outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients <18 years.

SETTING

University Hospital, Europe.

METHODS

A retrospective study of prospectively collected data of patients <18 years (childhood group; ChG) (n = 28) treated by LRYGB of which 19 were available for follow-up between 2.4 and 10.2 years (mean 7.2 years). This group of patients was matched with an adult control group (AdG) of randomly chosen patients with similar characteristics who underwent LRYGB during the same period. The extensive survey included a telephonic questionnaire.

RESULTS

19 (12 females) of the 28 patients (67.9%) were available for follow-up. Preoperatively, 3 had type 2 diabetes mellitus (T2DM), 1 arterial hypertension, 5 dyslipidemia and 1 sleep apnea. In the ChG, average BMI after 7 years dropped from 38.9 kg/m2 preoperatively to 27.5 kg/m2. In the AdG, average BMI decreased from 39.4 to 27.1 kg/m2 in the same time period (nonsignificant between groups). One patient in the ChG needed a reoperation (internal hernia) versus 3 patients in the AdG (1 leak, 2 obstructions). All patients resolved their initial comorbidities. Two of 12 female patients in the ChG became pregnant 6 and 8 years after surgery, respectively, despite seemingly adequate oral contraception. Compliance with postoperative guidelines was good in 16/19 patients in ChG and in 14/18 patients in the AdG. Overall degree of satisfaction was high: 8.2/10 (SD 1.2, range 6-10) in the ChG and 8.9/10 (SD 1.7, range 5-10) in the AdG.

CONCLUSION

LRYGB seems to be safe, provide good weight loss, and cure comorbidities in an adolescent population. Satisfaction degree is high. Inadvertent pregnancy despite conventional contraception is a possible issue.

摘要

背景

关于青少年肥胖症手术的数据很少。

目的

评估18岁以下患者接受腹腔镜Roux-en-Y胃旁路术(LRYGB)后的长期疗效。

地点

欧洲大学医院。

方法

对前瞻性收集的18岁以下患者(儿童组;ChG)(n = 28)的数据进行回顾性研究,其中19例患者在2.4至10.2年(平均7.2年)期间接受了随访。这组患者与同期接受LRYGB的随机选择的具有相似特征的成年对照组(AdG)进行匹配。广泛的调查包括电话问卷调查。

结果

28例患者中有19例(12例女性)(67.9%)接受了随访。术前,3例患有2型糖尿病(T2DM),1例患有动脉高血压,5例患有血脂异常,1例患有睡眠呼吸暂停。在儿童组中,7年后平均BMI从术前的38.9 kg/m²降至27.5 kg/m²。在成年对照组中,同期平均BMI从39.4降至27.1 kg/m²(组间无显著差异)。儿童组中有1例患者需要再次手术(内疝),而成年对照组中有3例患者(1例渗漏,2例梗阻)。所有患者的初始合并症均得到缓解。儿童组中12例女性患者中有2例分别在术后6年和8年怀孕,尽管采用了看似有效的口服避孕药。儿童组中16/19例患者和成年对照组中14/18例患者对术后指导的依从性良好。总体满意度较高:儿童组为8.2/10(标准差1.2,范围6 - 10),成年对照组为8.9/10(标准差1.7,范围5 - 10)。

结论

LRYGB在青少年人群中似乎是安全的,能有效减轻体重并治愈合并症。满意度较高。常规避孕措施下仍意外怀孕是一个可能出现的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f5/5644862/3611de2150c7/ofa-0009-0091-g01.jpg

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