St. Luke's University Health Network (SLUHN), Bethlehem, PA, USA.
Temple Lewis Katz School of Medicine, Philadelphia, PA, USA.
Obes Surg. 2021 Jan;31(1):194-199. doi: 10.1007/s11695-020-04866-w. Epub 2020 Jul 25.
Bariatric surgery is the only effective treatment of severe obesity. The number of adolescents undergoing bariatric surgery is increasing. However, bariatric surgery in adolescents is controversial.
The purpose of this study is to evaluate the outcomes of bariatric surgery in adolescents based on the MBSAQIP database (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project).
We analyzed the 2015-2017 MBSAQIP database; patients ≤ 19 years of age were included in our analysis. Primary outcomes were 30-day serious adverse events (SAEs), organ space infection (OSI), re-intervention, and re-operation rates. Secondary outcomes included operation length, hospital stay, and re-admission rates. We conducted separate Mann-Whitney rank sums tests, chi-square, or Fisher's exact tests as appropriate, with p < .05 denoting statistical significance.
A total of 1983 adolescent patients were included in our analysis. The average age and BMI were 18.1 and 47.5, respectively. Of adolescent patients, 21.7% underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) and 78.3% underwent laparoscopic sleeve gastrectomy (LSG). The 30-day SAE and readmission rates were significantly lower for LSG compared with LRYGB (2.9% and 2.6% vs 6.5% and 5.6%, respectively; p < 0.05). The 30-day reoperation rate was also lower for LSG compared with LRYGB albeit not significant (1.1% and vs 2.3%; p = 0.05). The 30-day intervention rate for LSG was significantly lower, however, compared with LRYGB (1.2% vs 3%; p < 0.05). Compared with adult patients, > 19 years old (n = 353,726), we found no difference in our outcomes. However, adolescents had significantly shorter operation length.
In adolescents, LSG had fewer SAE, re-intervention, and readmission rates compared with LRYGB. There was no difference in outcomes between adolescents and adults.
减重手术是治疗重度肥胖症的唯一有效方法。越来越多的青少年接受减重手术。然而，青少年减重手术存在争议。
本研究旨在根据 MBSAQIP 数据库（代谢和减重手术认证和质量改进项目）评估青少年减重手术的结果。
我们分析了 2015-2017 年 MBSAQIP 数据库；年龄≤19 岁的患者纳入我们的分析。主要结果为 30 天内严重不良事件（SAE）、器官空间感染（OSI）、再次干预和再次手术率。次要结果包括手术时间、住院时间和再入院率。我们进行了单独的 Mann-Whitney 秩和检验、卡方检验或 Fisher 精确检验，p<.05 表示具有统计学意义。
共纳入 1983 名青少年患者。平均年龄和 BMI 分别为 18.1 岁和 47.5。在青少年患者中，21.7%接受腹腔镜 Roux-en-Y 胃旁路术（LRYGB），78.3%接受腹腔镜袖状胃切除术（LSG）。与 LRYGB 相比，LSG 的 30 天 SAE 和再入院率显著降低（2.9%和 2.6%比 6.5%和 5.6%；p<.05）。与 LRYGB 相比，LSG 的 30 天再次手术率虽然不显著但也较低（1.1%和 2.3%；p=0.05）。然而，LSG 的 30 天干预率显著低于 LRYGB（1.2%比 3%；p<.05）。与成年患者（n=353726）相比，>19 岁，我们的结果没有差异。然而，青少年的手术时间明显缩短。
在青少年中，与 LRYGB 相比，LSG 的 SAE、再次干预和再入院率较低。青少年与成年患者的结果没有差异。
