Elhag Wahiba, El Ansari Walid
Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, 3050, Doha, Qatar.
Department of Surgery, Hamad General Hospital, 3050, Doha, Qatar.
Obes Surg. 2022 Feb;32(2):284-294. doi: 10.1007/s11695-021-05767-2. Epub 2021 Nov 13.
Globally, only two studies appraised the long-term nutritional status of adolescents after laparoscopic sleeve gastrectomy (LSG).
Retrospective chart review of all adolescents aged ≤ 18 years who underwent LSG with ≥ 5 years follow-up and had no subsequent revisional surgery (N = 146). We assessed 15 nutritional parameters preoperatively and at 1, 3, 5, 7, and 9 years post surgery.
Mean age was 16.51 ± 1.29 years, 51% were males. We identified three patterns: 1) Significant worsening of preoperative deficiencies: 4.7% and 0.8% of the sample exhibited zinc and vitamin B12 deficiencies, worsening to 20.8% and 12.8% at 1 year, respectively. Likewise, 0.7% of the sample had low total protein, worsening to 8.3% at year 3. A total of 32.4% of females had preoperative low hemoglobin worsening to 57.9% at year 5. 2) Significant improvement: the percentage of males with preoperative low hemoglobin (5.6%) was reduced to 4.1% and 5.1% at years 1 and 3, respectively. 3) Persistent deficiency: all (100%) of adolescents had preoperative vitamin D deficiency that persisted through years 3 and 9 at 90.5% and 100%, respectively. The most common complications were food intolerance (51%), vomiting (47.5%), gastritis/ esophagitis (35.7%), and gastroesophageal reflux disease (20.3%). We observed one case of Wernicke's encephalopathy. Across the 9 years, 15.4% of the adolescents underwent intra-abdominal surgeries where 12.6% had cholecystectomy and one patient had appendectomy.
Adolescents had several preoperative nutritional deficiencies, most of which worsened or persisted on the long term. This is the first study among adolescents to assess such deficiencies beyond 5 years.
在全球范围内，仅有两项研究评估了青少年接受腹腔镜袖状胃切除术（LSG）后的长期营养状况。
对所有年龄≤18岁且接受了LSG并进行了≥5年随访且无后续翻修手术的青少年进行回顾性病历审查（N = 146）。我们在术前以及术后1、3、5、7和9年评估了15项营养参数。
平均年龄为16.51±1.29岁，51%为男性。我们确定了三种模式：1）术前缺乏症显著恶化：样本中4.7%和0.8%的人存在锌和维生素B12缺乏，分别在1年时恶化至20.8%和12.8%。同样，样本中0.7%的人总蛋白水平低，在第3年恶化至8.3%。共有32.4%的女性术前血红蛋白水平低，在第5年恶化至57.9%。2）显著改善：术前血红蛋白水平低的男性比例（5.6%）在第1年和第3年分别降至4.1%和5.1%。3）持续缺乏：所有（100%）青少年术前均存在维生素D缺乏，在第3年和第9年分别有90.5%和100%的人持续存在该缺乏情况。最常见的并发症是食物不耐受（51%）、呕吐（47.5%）、胃炎/食管炎（35.7%）和胃食管反流病（20.3%）。我们观察到1例韦尼克脑病病例。在这9年中，15.4%的青少年接受了腹腔内手术，其中12.6%进行了胆囊切除术且1例患者进行了阑尾切除术。
青少年术前存在多种营养缺乏情况，其中大多数在长期内恶化或持续存在。这是第一项在青少年中评估5年以上此类缺乏情况的研究。
