Arumalla Kirit, Singla Vitish, Aggarwal Sandeep, Garg Harshit, Goel Ritesh, Katiyar Varidh
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
J Minim Access Surg. 2019 Jan-Mar;15(1):31-36. doi: 10.4103/jmas.JMAS_143_17.
There is a worldwide increase in the prevalence of obesity among the adolescent population in India from 16.3% in 2001 to 19.3% in 2010. Recent evidence suggests that bariatric surgery leads to resolution of comorbidities and associated long-term complications in adolescent patients with morbid obesity.
The aim of this study is to determine the impact of bariatric surgery on the weight loss and comorbidities of morbidly obese adolescents.
A retrospective review of the data of 10 adolescent patients, who underwent Laparoscopic Sleeve Gastrectomy at our institute (tertiary care hospital), from July 2009 to July 2016 was carried out.
Of the 10 patients, 4 patients had syndromic forms of obesity. The median age was 16.54 years. The median pre-operative weight and height were 112 kg and 154 cm, respectively, with a body mass index of 47.2 kg/m. There was no intra-operative or post-operative complication except for suspected methylene blue toxicity in one patient which was treated conservatively. Median follow-up period was 1 year (0-5 years). The patients had an increase in excess weight loss (EWL) of 54.5% until the end of 1 year. There was a regain of weight between the 1 and 2 year, followed by a sustained weight loss achieving 44.8% EWL at 3 years and 60% at the end of 5 years (only two patients followed up at 5 years). Similar results were found in syndromic patients. Among the four diabetic patients, three had complete resolution and one had improvement in diabetes status. Among the three patients with obstructive sleep apnoea, two patients had complete resolution, while one patient had improvement in symptoms. One patient with hypocortisolism improved after surgery with a decrease in the steroid requirement. Among the hypothyroid patients, one patient had a complete resolution, one patient had improvement in hypothyroid status while two patients had no change.
Bariatric surgery is effective for morbidly obese adolescents, leading to significant resolutions of comorbid illness.
在印度，青少年肥胖症的患病率在全球范围内呈上升趋势，从2001年的16.3%升至2010年的19.3%。最近的证据表明，减肥手术可使患有严重肥胖症的青少年患者的合并症及相关长期并发症得到缓解。
本研究的目的是确定减肥手术对严重肥胖青少年体重减轻及合并症的影响。
对2009年7月至2016年7月在我院（三级护理医院）接受腹腔镜袖状胃切除术的10例青少年患者的数据进行回顾性分析。
10例患者中，4例患有综合征型肥胖症。中位年龄为16.54岁。术前体重和身高的中位数分别为112 kg和154 cm，体重指数为47.2 kg/m²。除1例患者疑似亚甲蓝中毒经保守治疗外，无术中或术后并发症。中位随访期为1年（0至5年）。患者在1年末的超重减轻（EWL）增加了54.5%。在第1年和第2年之间体重有所反弹，随后体重持续减轻，在3年时EWL达到44.8%，在5年末达到60%（仅2例患者随访至5年）。综合征型患者也有类似结果。4例糖尿病患者中，3例完全缓解，1例糖尿病病情改善。3例阻塞性睡眠呼吸暂停患者中，2例完全缓解，1例症状改善。1例肾上腺皮质功能减退患者术后病情改善，类固醇需求量减少。在甲状腺功能减退患者中，1例完全缓解，1例甲状腺功能减退病情改善，2例无变化。
减肥手术对严重肥胖青少年有效，可使合并症得到显著缓解。
