Iossa Angelo, De Peppo Francesco, Caccamo Romina, Watkins Brad Michael, Abbatini Francesca, Ceriati Emanuela, Silecchia Gianfranco
Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, "La Sapienza", University of Rome, Rome, Italy.
Department of Paediatric Surgery, Hospital Bambino Gesù", Palidoro (Rm), Italy.
Eat Weight Disord. 2018 Aug;23(4):479-486. doi: 10.1007/s40519-016-0348-7. Epub 2017 Jan 9.
Childhood obesity is an emerging health problem. Surgical treatment of obese adolescents, particularly those affected by congenital syndrome, represents a controversial issue. The aim of this multicenter study was to retrospectively assess the results of laparoscopic sleeve gastrectomy (LSG) in a cohort of adolescents affected by morbid obesity, with or without congenital syndromes.
Forty-one obese (BMI 49 ± 6 kg/m) adolescents with mean age of 16 ± 3 years (58.5% with previous intragastric balloon failure), and subjected to LSG, were retrospectively evaluated for complications rate, % excess weight loss (%EWL), and inhibition of co-morbidities after 2 years of follow-up.
All the operations were completed laparoscopically and no intra-operative complications were recorded. No mortality was recorded while peri- or post-operative complications only occurred in two patients (4.9%). The EWL% at 6, 12, and 24 months were 42.3, 58.3, and 59.4, respectively. %EWL was comparable (p = 0.7) between non-syndromic and syndromic obese adolescents at 24 months. Conversely patients with previous intragastric balloon surgery had a significant lower EWL (%) at 24 month (p < 0.01). Moreover, at the same time point, co-morbidity resolution rate was 78.2% while improvement rate was 57.6%. Specifically, remission rate of type 2 diabetes (T2DM), hypertension and obstructive sleep apnea (OSA) were 71, 75 and 61%, respectively.
LSG is advantageous in the treatment of morbidly obese juveniles concerning safety, weight loss and co-morbidity control and at same time presenting, a possible effective therapeutic option for patients affected by congenital syndrome.
儿童肥胖是一个新出现的健康问题。肥胖青少年的手术治疗，尤其是那些受先天性综合征影响的青少年，是一个有争议的问题。这项多中心研究的目的是回顾性评估腹腔镜袖状胃切除术（LSG）在一组患有病态肥胖的青少年中的效果，这些青少年有无先天性综合征。
对41名肥胖（BMI 49±6kg/m²）青少年进行回顾性评估，这些青少年平均年龄为16±3岁（58.5%曾有胃内球囊置入失败经历），接受了LSG手术，随访2年后评估其并发症发生率、超重减轻百分比（%EWL）以及合并症的抑制情况。
所有手术均通过腹腔镜完成，术中未记录到并发症。无死亡病例，围手术期或术后并发症仅发生在2名患者（4.9%）。6个月、12个月和24个月时的EWL%分别为42.3%、58.3%和59.4%。24个月时，非综合征性和综合征性肥胖青少年的%EWL具有可比性（p = 0.7）。相反，曾接受胃内球囊手术的患者在24个月时的EWL（%）显著较低（p < 0.01）。此外，在同一时间点，合并症缓解率为78.2%，改善率为57.6%。具体而言，2型糖尿病（T2DM）、高血压和阻塞性睡眠呼吸暂停（OSA）的缓解率分别为71%、75%和61%。
LSG在治疗病态肥胖青少年方面在安全性、体重减轻和合并症控制方面具有优势，同时对于受先天性综合征影响的患者也是一种可能有效的治疗选择。
