Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.
Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.
Surg Obes Relat Dis. 2018 Sep;14(9):1368-1372. doi: 10.1016/j.soard.2018.04.004. Epub 2018 Apr 19.
With the rise of obesity in adolescents, there is an exponential increase in bariatric procedures in this patient population.
The purpose of our study was to examine perioperative outcomes after bariatric surgery in this cohort.
University hospital, involving a large database in New York State.
The Metabolic and Bariatric Surgery Accreditation Quality and Improvement Program public use file was queried to identify all adolescent patients (age <19 years) undergoing primary laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in 2015. We assessed 30-day postoperative complications.
We identified 1072 patients who underwent Roux-en-Y gastric bypass (n = 279) or SG (n = 793). The majority were Caucasian (n = 790) and female (n = 857) with mean body mass index and age of 47.9 ± 8.1 kg/m and 18.2 ± 1 years, respectively, preoperative hypertension, type 2 diabetes, and obstructive sleep apnea were present in 90 (8.4%), 139 (13%), and 165 (15.4%) of patients, respectively. There was significant difference in preoperative gastroesophageal reflux disease (18.6% versus 13.4%, P = .033), obstructive sleep apnea (19.7% versus 13.9%, P = .02), and body mass index (48.6 ± 7.9 versus 47.6 ± 8.2 kg/m, P = .03) between patients undergoing Roux-en-Y gastric bypass and SG, respectively. Thirty-day reoperation, readmission, and reintervention were reported in 1.5%, 3.3%, and 1.6% of the adolescent cohort, respectively. Four patients (.4%) developed a staple line/anastomotic leak, and 1 patient (.09%) died within 30 days; 93.9% of all adolescent patients experienced an uneventful 30-day recovery. Uneventful recovery was significantly more likely for patients undergoing SG (95.3% versus 90%, P = .001; adjusted odds ratio 2.2, 95% confidence interval 1.31-3.69).
Perioperative safety of bariatric surgery in adolescents in accredited centers is safer than previously reported with low rate of 30-day events. SG is a safer procedure in this patient population.
随着青少年肥胖的增加，此类患者人群的减重手术数量呈指数级增长。
我们的研究旨在研究该队列接受减重手术后的围手术期结果。
大学医院，涉及纽约州的一个大型数据库。
查询代谢和减重手术认证质量和改进计划公共使用文件，以确定所有在 2015 年接受原发性腹腔镜 Roux-en-Y 胃旁路术（RYGB）或袖状胃切除术（SG）的青少年患者（年龄<19 岁）。我们评估了 30 天术后并发症。
我们确定了 1072 名接受 Roux-en-Y 胃旁路术（n=279）或 SG（n=793）的患者。大多数患者为白种人（n=790）和女性（n=857），平均体重指数和年龄分别为 47.9±8.1kg/m 和 18.2±1 岁，术前高血压、2 型糖尿病和阻塞性睡眠呼吸暂停分别存在于 90（8.4%）、139（13%）和 165（15.4%）的患者中。RYGB 组与 SG 组患者术前胃食管反流病（18.6%比 13.4%，P=0.033）、阻塞性睡眠呼吸暂停（19.7%比 13.9%，P=0.02）和体重指数（48.6±7.9 比 47.6±8.2kg/m，P=0.03）存在显著差异。在青少年组中，30 天再手术、再入院和再干预分别占 1.5%、3.3%和 1.6%。有 4 名患者（1.5%）发生吻合口漏，1 名患者（0.09%）在 30 天内死亡；所有青少年患者中有 93.9%在 30 天内顺利康复。SG 组患者的无并发症恢复率明显更高（95.3%比 90%，P=0.001；调整后的优势比为 2.2，95%置信区间为 1.31-3.69）。
在认证中心，青少年减重手术的围手术期安全性比以前报道的更安全，30 天内事件发生率低。SG 是该患者群体中更安全的手术。
