Norain Abdullah, Arafat Mohammad, Burjonrappa Sathyaprasad
Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467-2401, USA.
Obes Surg. 2019 Aug;29(8):2511-2516. doi: 10.1007/s11695-019-03867-8.
Many factors, including preoperative weight, may determine final weight loss after bariatric surgery; however, their proportional contribution is unclear. To such end, we evaluated weight loss patterns among obese adolescents.
We evaluated 57 adolescents who underwent laparoscopic sleeve gastrectomy from 2011 to 2017. Data collection included demographics, anthropometrics, and comorbidities and was done over a 3-year follow-up period. Statistical analysis was performed using Student's t test and repeated measures ANOVA.
In the morbidly obese (MO) group, 82% were female, while 52% were male in the super obese (SMO) group (P < 0.0059). While 13/34 patients in the obese group achieved > 60% percent excess body weight loss (%EBWL), only 3/23 super obese patients achieved > 60% EBWL (P = 0.0695). %EBWL at 1-year follow-up significantly differed between the obese and super obese groups, 61.7 ± 14.6% and 47.7 ± 14.9% respectively (P = 0.035). The average BMI in the obese group was 29.8 at 1 year and 41.3 in the super obese group. There was a significant difference in the rate of excess weight loss (%EBWL/month) between the two groups (P < 0.01). There was good comorbidity resolution (about 70%) in both groups after surgery.
Comorbidity resolution after sleeve gastrectomy is excellent in the adolescent population irrespective of initial BMI. Consideration should be given to earlier bariatric intervention in SMO adolescents to facilitate return to near normal BMI. Focus on education of referral sources, such as community pediatricians and family practitioners to facilitate early bariatric evaluation should be considered. Weight loss in postsurgical SMO patients should be carefully monitored and adjunctive interventions should be considered.
包括术前体重在内的许多因素可能决定减肥手术后的最终体重减轻情况；然而，它们各自的贡献比例尚不清楚。为此，我们评估了肥胖青少年的体重减轻模式。
我们评估了2011年至2017年接受腹腔镜袖状胃切除术的57名青少年。数据收集包括人口统计学、人体测量学和合并症，并在3年的随访期内完成。采用学生t检验和重复测量方差分析进行统计分析。
在病态肥胖（MO）组中，82%为女性，而在超级肥胖（SMO）组中，52%为男性（P < 0.0059）。肥胖组34例患者中有13例实现了>60%的超重体重减轻（%EBWL），而超级肥胖组23例患者中只有3例实现了>60%的EBWL（P = 0.0695）。肥胖组和超级肥胖组在1年随访时的%EBWL有显著差异，分别为61.7±14.6%和47.7±14.9%（P = 0.035）。肥胖组1年时的平均BMI为29.8，超级肥胖组为41.3。两组之间的超重体重减轻率（%EBWL/月）有显著差异（P < 0.01）。两组术后合并症缓解情况良好（约70%）。
无论初始BMI如何，青少年人群行袖状胃切除术后合并症缓解情况良好。应考虑对超级肥胖青少年进行早期减肥干预，以促进恢复至接近正常的BMI。应考虑加强对转诊来源（如社区儿科医生和家庭医生）的教育，以促进早期减肥评估。术后超级肥胖患者的体重减轻情况应仔细监测，并应考虑辅助干预措施。
