Division of Pediatric Cardiology, East Carolina University, Brody School of Medicine, Greenville, NC, USA.
Department of Pediatrics, John R. Oishei Children's Hospital, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Pediatr Res. 2020 Jan;87(2):202-209. doi: 10.1038/s41390-019-0532-3. Epub 2019 Aug 11.
The selection criteria, safety, and efficacy of bariatric surgery are well established in adults but are less well defined for severely obese adolescents. The number of severely obese adolescents who could benefit from weight loss surgery is increasing, although referral rates have plateaued. Surgical options for these adolescents are controversial and raise several questions. Recent studies, including the prospective Teen-Longitudinal Assessment of Bariatric Surgery Study and the Adolescent Morbid Obesity Surgery Study, help answer these questions. Early bariatric surgical intervention improves body mass index but, more importantly, improves cardiovascular and metabolic co-morbidities of severe obesity. A review of the medical, psychosocial, and economic risks and benefits of bariatric surgery in severely obese adolescents is a step toward improving the management of a challenging and increasing population. We describe the current knowledge of eligibility criteria, preoperative evaluation, surgical options, outcomes, and referral barriers of adolescents for bariatric surgery.
肥胖青少年的减肥手术适应证、安全性和疗效虽不如成人明确，但已得到充分证实。尽管转介率已趋于平稳，但能够从减重手术中获益的严重肥胖青少年人数仍在不断增加。这些青少年的手术选择存在争议，并引发了一些问题。包括前瞻性青少年减重手术纵向评估研究和青少年病态肥胖手术研究在内的近期研究有助于解答这些问题。早期行减肥手术干预不仅可改善体重指数，而且更重要的是可改善严重肥胖的心血管和代谢合并症。对严重肥胖青少年减肥手术的医疗、心理社会和经济风险与获益进行评估是改善挑战性和不断增加的肥胖人群管理的重要一步。我们描述了目前关于青少年减肥手术适应证、术前评估、手术选择、结局和转介障碍的相关知识。
