Atrium Health Weight Management, Section of Bariatric & Metabolic Surgery, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina.
Division of Research, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina.
Surg Obes Relat Dis. 2020 Oct;16(10):1463-1473. doi: 10.1016/j.soard.2020.05.028. Epub 2020 Jun 10.
Obesity in the United States is increasingly prevalent in adolescents. Metabolic and bariatric surgery is offered at select sites to adolescents (<18 yr). Controversy exists regarding the safety of performing metabolic and bariatric surgery in adolescents.
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry was employed to compare outcomes of adolescents with adults (18-40 yr) undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).
Academic Teaching Institution.
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant User Files were reviewed for patients undergoing SG or RYGB (2015-2018). Patients were stratified by age and outcomes for adolescents versus adults compared. A bivariate analysis was performed on propensity-matched data.
After exclusion criteria were applied, 227,671 patients <40 years remained, of whom 1005 were adolescents. For those undergoing RYGB (13.8% adolescents, 25.3% adults), demographic characteristics were similar. Adolescent SG patients were more likely to be male and Hispanic, but less likely to be smokers or have preoperative co-morbidities. There were no differences in infection rates, mortality, major complications, reoperation, readmission, or other interventions for RYGB and SG groups. For both adult SG and adolescent SG, patients' operative times were less than adult and adolescent RYGB, respectively. However, operative times were shorter for adolescent RYGB versus adult RYGB patients, yet longer for adolescent SG patients versus adult SG patients.
Metabolic and bariatric surgery is as safe for adolescents undergoing an SG or RYGB as adults. Currently, SG is more commonly performed in adolescents than RYGB, and adolescent SG patients have similar outcomes and shorter operating room times compared with adolescent RYGB patients.
肥胖在美国青少年中越来越普遍。代谢和减重手术在一些特定的场所提供给青少年（<18 岁）。对于在青少年中进行代谢和减重手术的安全性存在争议。
代谢和减重手术认证和质量改进计划登记处被用来比较接受袖状胃切除术（SG）或 Roux-en-Y 胃旁路术（RYGB）的青少年与成年人（18-40 岁）的结果。
学术教学机构。
对代谢和减重手术认证和质量改进计划参与者用户文件进行了回顾，以评估 2015-2018 年间接受 SG 或 RYGB 的患者。根据年龄对患者进行分层，并比较青少年与成年人的结果。对倾向匹配数据进行了双变量分析。
应用排除标准后，<40 岁的患者有 227671 例，其中 1005 例为青少年。对于接受 RYGB（13.8%的青少年，25.3%的成年人）的患者，人口统计学特征相似。青少年 SG 患者更可能是男性和西班牙裔，但不太可能是吸烟者或有术前合并症。RYGB 和 SG 组在感染率、死亡率、主要并发症、再次手术、再入院或其他干预方面没有差异。对于成人 SG 和青少年 SG，患者的手术时间均短于成人和青少年 RYGB。然而，青少年 RYGB 的手术时间短于成人 RYGB，但长于青少年 SG 患者。
代谢和减重手术对接受 SG 或 RYGB 的青少年和成年人同样安全。目前，SG 在青少年中比 RYGB 更常见，青少年 SG 患者的结果与青少年 RYGB 患者相似，且手术时间更短。
