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新加坡针对病态肥胖青少年的腹腔镜袖状胃切除术。

Laparoscopic sleeve gastrectomy for morbidly obese adolescents in Singapore.

作者信息

Dargan Dallan, Dolgunov Dmitrii, Soe Khin Thida, Er Pamela, Naseer Fathimath, Lomanto Davide, So Jimmy By, Shabbir Asim

机构信息

Department of Surgery, National University Hospital, Singapore.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

Singapore Med J. 2018 Feb;59(1):98-103. doi: 10.11622/smedj.2017086. Epub 2017 Oct 6.

Abstract

INTRODUCTION

Laparoscopic sleeve gastrectomy (LSG) outcomes among adolescents and factors associated with adolescent obesity in Singapore were evaluated.

METHODS

Prospectively collected data of patients aged 16-19 years who underwent LSG was retrospectively reviewed. A lifestyle questionnaire, Berlin and Epworth scores, and Patient Health Questionnaire-9 scores were collected. Preoperative anthropometrics, comorbidities, weight loss and body composition outcomes were recorded.

RESULTS

Among 208 LSGs, 13 (6.3%) were performed on obese adolescents. Mean age and body mass index (BMI) at first presentation were 19.1 ± 0.9 (range 16.8-19.8) years and 46.2 ± 6.3 (range 36-57) kg/m, respectively. There was family history of obesity (n = 7) and regular consumption of high-calorie drinks (n = 12). Most patients had comorbidities (n = 12), including hypertension (n = 5), asthma (n = 4), diabetes mellitus (n = 3), hernia (n = 3) and obstructive sleep apnoea requiring continuous positive airway pressure support (n = 3). At one year, excess weight loss was 64.3% ± 34.7% (range 21.8%-101.5%), while BMI and fat mass dropped to 31.2 ± 7.6 (range 23-40) kg/m and 17.4 kg, respectively. Pain score was 2/10 at 24 hours after surgery. Mean postoperative stay was 2.7 days. No complications or readmissions occurred. Remission of diabetes mellitus and hypertension was reported in two of three and four of five adolescents, respectively, within one year of surgery.

CONCLUSION

LSG is a safe option for adolescents with good short-term weight loss outcomes and remission of metabolic comorbid conditions.

摘要

引言

对新加坡青少年腹腔镜袖状胃切除术(LSG)的结果以及与青少年肥胖相关的因素进行了评估。

方法

对前瞻性收集的16至19岁接受LSG患者的数据进行回顾性分析。收集了生活方式问卷、柏林和爱泼沃斯评分以及患者健康问卷-9评分。记录术前人体测量学、合并症、体重减轻和身体成分结果。

结果

在208例LSG手术中,13例(6.3%)为肥胖青少年。首次就诊时的平均年龄和体重指数(BMI)分别为19.1±0.9(范围16.8-19.8)岁和46.2±6.3(范围36-57)kg/m²。有肥胖家族史(n = 7)和经常饮用高热量饮料(n = 12)。大多数患者有合并症(n = 12),包括高血压(n = 5)、哮喘(n = 4)、糖尿病(n = 3)、疝气(n = 3)和需要持续气道正压支持的阻塞性睡眠呼吸暂停(n = 3)。术后一年,超重减轻了64.3%±34.7%(范围21.8%-101.5%),而BMI和脂肪量分别降至31.2±7.6(范围23-40)kg/m²和17.4kg。术后24小时疼痛评分为2/10。术后平均住院时间为2.7天。未发生并发症或再次入院情况。在术后一年内,分别有三名青少年中的两名和五名青少年中的四名报告糖尿病和高血压缓解。

结论

LSG是青少年的一种安全选择,具有良好的短期体重减轻效果和代谢合并症缓解情况。

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