腹腔镜胃折叠术治疗青少年重度肥胖症的初步研究。

A pilot study of laparoscopic gastric plication in adolescent patients with severe obesity.

机构信息

Department of Surgery, Virginia Commonwealth University Medical Center, West Hospital 15(th) Floor Box 980645, Richmond, VA 23298.

Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth, University, Box 980140, Richmond, VA 23298.

出版信息

J Pediatr Surg. 2019 Aug;54(8):1696-1701. doi: 10.1016/j.jpedsurg.2019.01.004. Epub 2019 Jan 23.

DOI:10.1016/j.jpedsurg.2019.01.004

PMID:30765155

Abstract

BACKGROUND

Metabolic and bariatric surgery in adolescents with severe obesity has been demonstrated to be safe and have long-term treatment efficacy. However, less than 0.1% of adolescents meeting criteria undergo surgery.

METHODS

A prospective pilot study of adolescents who underwent laparoscopic gastric plication (LGP) was conducted to evaluate safety and effects on anthropometrics and weight-related medical and psychological comorbidities.

RESULTS

Four adolescents enrolled and underwent LGP; two withdrew 90 days postoperatively and two were followed through 36 months. Preprocedure body mass index was 41.7-53.7 kg/m with decreases in % change of BMI of 17.5% and 39.7% at 36 months after surgery. Patients reported early satiety, good hunger control, and limited nausea at all time points. There were no major complications. Mild gastroesophageal reflux and abdominal pain occurred; both resolved without surgical intervention. Minor improvements in psychological comorbidities were also reported.

CONCLUSIONS

LGP can be safely performed in adolescents with severe obesity and achieves modest weight loss. Although limited by its small sample size, this study provides preliminary support for LGP as an appropriate surgical option for adolescents. A larger, multidisciplinary study is planned.

TYPE OF STUDY

Prospective case series review.

LEVEL OF EVIDENCE

Level IV evidence: case series without comparison.

摘要

背景

代谢和减重手术在严重肥胖的青少年中已被证明是安全的，并且具有长期的治疗效果。然而，符合手术标准的青少年中，不到 0.1%接受了手术。

方法

对接受腹腔镜胃折叠术（LGP）的青少年进行了一项前瞻性试点研究，以评估安全性以及对人体测量学和与体重相关的医疗和心理合并症的影响。

结果

有 4 名青少年入组并接受了 LGP；2 名在术后 90 天退出，2 名随访至 36 个月。术前体重指数为 41.7-53.7kg/m，术后 36 个月 BMI 的变化百分比分别下降了 17.5%和 39.7%。患者报告在所有时间点都有早饱感、良好的饥饿控制和有限的恶心。没有发生重大并发症。出现轻度胃食管反流和腹痛，但无需手术干预即可缓解。心理合并症也有轻微改善。