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腹腔镜袖状胃切除术作为青少年病态肥胖的一线手术治疗方法。

Laparoscopic sleeve gastrectomy as first-line surgical treatment for morbid obesity among adolescents.

作者信息

Ejaz Aslam, Patel Pankti, Gonzalez-Heredia Raquel, Holterman Mark, Elli Enrique F, Kanard Robert

机构信息

Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL.

Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL.

出版信息

J Pediatr Surg. 2017 Apr;52(4):544-548. doi: 10.1016/j.jpedsurg.2016.08.023. Epub 2016 Sep 3.

Abstract

BACKGROUND

The increasing prevalence of obesity has necessitated the increasing use of bariatric surgery in the adolescent population. Outcomes following laparoscopic sleeve gastrectomy (LSG) among adolescents, however, have not been well-studied. We report outcomes following LSG as a first-line surgical therapy in patients under 21years of age.

METHODS

All patients who underwent LSG as a primary surgical option for morbid obesity were identified at the University of Illinois at Chicago between 2006 and 2014. Standard clinicopathologic and outcomes data were recorded.

RESULTS

We identified 18 patients (13 females, 5 males) who underwent LSG. Mean patient age was 17.8±1.7years. Mean BMI among all patients was 48.6±7.2kg/m and did not differ by gender (P=0.68). One patient (5.6%) experienced a 30-day perioperative complication (pulmonary embolism). Median LOS following LSG was 3days (IQR: 2, 3). 2 patients (11.1%) were readmitted within 30-days because of feeding intolerance that resolved without invasive intervention. At a median follow-up of 10.6 (range: 0-38) months, percent excess weight loss (%EWL) among all patients was 35.6%. Among patients with at least 2years follow-up (n=3), %EWL was 50.2%.

CONCLUSIONS

Laparoscopic sleeve gastrectomy in morbidly obese adolescents is a safe and feasible option. Short- and long-term weight loss appears to be successful following LSG. As such, LSG should be strongly considered as a primary surgical treatment option for all morbidly obese adolescents.

LEVEL OF EVIDENCE

Level IV.

摘要

背景

肥胖症患病率不断上升,使得青少年人群中减肥手术的使用日益增加。然而,青少年腹腔镜袖状胃切除术(LSG)后的结果尚未得到充分研究。我们报告了LSG作为21岁以下患者一线手术治疗后的结果。

方法

2006年至2014年期间,在伊利诺伊大学芝加哥分校确定了所有接受LSG作为病态肥胖主要手术选择的患者。记录了标准的临床病理和结果数据。

结果

我们确定了18例接受LSG的患者(13例女性,5例男性)。患者平均年龄为17.8±1.7岁。所有患者的平均BMI为48.6±7.2kg/m²,且无性别差异(P=0.68)。1例患者(5.6%)发生了30天围手术期并发症(肺栓塞)。LSG后的中位住院时间为3天(IQR:2,3)。2例患者(11.1%)在30天内因喂养不耐受再次入院,未经侵入性干预即缓解。在中位随访10.6(范围:0 - 38)个月时,所有患者的超重减轻百分比(%EWL)为35.6%。在至少随访2年的患者中(n = 3),%EWL为50.2%。

结论

病态肥胖青少年的腹腔镜袖状胃切除术是一种安全可行的选择。LSG后短期和长期体重减轻似乎是成功的。因此,应强烈考虑将LSG作为所有病态肥胖青少年的主要手术治疗选择。

证据级别

IV级。

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