Thenappan Arunachalam, Nadler Evan
Division of Pediatric General and Thoracic Surgery, The George Washington University School of Medicine & Health Sciences, 111 Michigan Avenue NW, Washington, DC, 20010, USA.
Curr Gastroenterol Rep. 2019 Apr 25;21(6):24. doi: 10.1007/s11894-019-0691-8.
The purpose of this review is to discuss the current state of surgical intervention for obesity in children and adolescents. Specifically, this review will discuss the different types of metabolic and bariatric surgery (MBS) procedures, guidelines for patient selection, and recent findings regarding surgical outcomes and complications.
MBS is safe in adolescents and has also demonstrated sustainable long term weight loss and improvement in obesity-associated comorbidities. A recent prospective multi-institutional trial demonstrated BMI reductions of 3.8 kg/m (8%) to 15.1 kg/m (28%) after 3 years among adolescents undergoing the three most common MBS procedures. Moreover, MBS is associated with remission of type 2 diabetes, prediabetes, hypertension, dyslipidemia, and abnormal kidney function in 65-95% of patients in the study. Childhood and adolescent obesity is a continuing problem that has not been adequately addressed by the medical community. MBS is currently the most successful strategy for significant and sustained weight loss and improvement of associated comorbidities. This review focuses on the different types of MBS, the selection and preparation of patients for surgery, and the expected outcomes and common complications.
本综述旨在探讨儿童和青少年肥胖症手术干预的现状。具体而言，本综述将讨论不同类型的代谢和减重手术（MBS）程序、患者选择指南以及有关手术结果和并发症的最新研究结果。
MBS在青少年中是安全的，并且还显示出可持续的长期体重减轻以及肥胖相关合并症的改善。最近一项前瞻性多机构试验表明，接受三种最常见MBS手术的青少年在3年后BMI降低了3.8kg/m（8%）至15.1kg/m（28%）。此外，在该研究中，65-95%的患者MBS与2型糖尿病、糖尿病前期、高血压、血脂异常和肾功能异常的缓解相关。儿童和青少年肥胖是一个持续存在的问题，医学界尚未充分解决。MBS目前是实现显著且持续体重减轻以及改善相关合并症的最成功策略。本综述重点关注不同类型的MBS、手术患者的选择和准备，以及预期结果和常见并发症。
