Department of Paediatric Surgery, King's College Hospital, Denmark Hill, London, SE9 5RS, UK.
Curr Obes Rep. 2017 Sep;6(3):278-285. doi: 10.1007/s13679-017-0277-4.
In spite of the increasing prevalence of severe and complex obesity in children, surgery as a potential management option is still not widely accepted. The purpose of this review is to examine the evidence for surgical options in the severely obese paediatric population. Increasing evidence supports early rather than later use of bariatric surgery in the treatment of extreme obesity.
Prior to 2007, the feasibility and safety of surgery have been reported by predominantly small, sporadic single-centre retrospective case series. Increasing long-term data is now emerging due to the formation of multi-centre prospective national consortiums with two large, prospective long-term outcome studies published within the last year aiding our understanding of the efficacy and safety of bariatric surgery within the adolescent population. It is increasingly clear that adolescent bariatric surgery outcomes are comparable to adults, with similar sustainable weight loss, resolution of co-morbidities and complication rates. However, these studies are solely from dedicated specialist adolescent centres and results may not be reproducible if not performed in regulated environments with specialist multi-disciplinary teams.
尽管儿童重度和复杂肥胖的患病率不断增加，但手术作为一种潜在的治疗选择仍未被广泛接受。本综述的目的是研究严重肥胖儿童人群的手术选择证据。越来越多的证据支持在治疗极度肥胖症时尽早而不是延迟使用减肥手术。
在 2007 年之前，主要是由小型、分散的单中心回顾性病例系列报告了手术的可行性和安全性。由于形成了多中心前瞻性国家联盟，以及过去一年发表的两项大型前瞻性长期结果研究，现在越来越多的长期数据正在出现，这有助于我们了解青少年人群中减肥手术的疗效和安全性。越来越明显的是，青少年减肥手术的结果与成年人相当，具有相似的可持续减重、合并症的解决和并发症发生率。然而，这些研究仅来自专门的青少年中心，如果不在具有专业多学科团队的监管环境中进行，结果可能无法重现。
