Department of Brain and Behavioral Sciences, University of Pavia, Italy; Bariatric Surgery Team, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
Nutrition. 2019 May;61:67-69. doi: 10.1016/j.nut.2018.10.033. Epub 2018 Nov 7.
Prader-Willi syndrome (PWS) is a complex genetic disorder and represents the most common genetic cause of life-threatening obesity in childhood and adolescence. The indication for bariatric surgery in children and adolescents with syndromic obesity is still controversial. This case report deals with the preoperative medical and psychosocial evaluation of a 16-y-old male adolescent with PWS who underwent sleeve gastrectomy. Information on a 6-mo follow-up is also reported. The preoperative body weight was 223 kg (body mass index [BMI] 80.9 kg/m). Comorbidities included severe obstructive sleep apnea with nocturnal respiratory failure, hypertension, and impaired glucose tolerance. At 2- and 6-mo follow-ups, the percent excess weight loss was 16 (BMI 71.8 kg/m) and 29.2 (BMI 64.6 kg/m), respectively. Comorbities did improve. Intellectual disability of genetic origin per se may not represent an absolute contraindication to bariatric surgery if adequate and tailored clinical and psychosocial support is provided.
普拉德-威利综合征（PWS）是一种复杂的遗传疾病，是儿童和青少年时期危及生命的肥胖的最常见遗传原因。综合征性肥胖儿童和青少年行减重手术的指征仍存在争议。本病例报告介绍了一例 PWS 男性青少年接受袖状胃切除术的术前医学和社会心理评估。还报告了 6 个月的随访信息。术前体重为 223 公斤（体重指数 [BMI] 80.9 kg/m）。合并症包括严重阻塞性睡眠呼吸暂停伴夜间呼吸衰竭、高血压和葡萄糖耐量受损。在 2 个月和 6 个月的随访时，体重超标百分比分别为 16（BMI 71.8 kg/m）和 29.2（BMI 64.6 kg/m）。合并症有所改善。如果提供充分和量身定制的临床和社会心理支持，遗传起源的智力障碍本身不一定是减重手术的绝对禁忌症。
