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青少年代谢和减重手术后的长期结果。

Long-term Outcomes Following Adolescent Metabolic and Bariatric Surgery.

机构信息

Department of General Surgery, Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, Swansea, UK.

Department of Medicine, Swansea University Medical School, Swansea, UK.

出版信息

J Clin Endocrinol Metab. 2023 Aug 18;108(9):2184-2192. doi: 10.1210/clinem/dgad155.

Abstract

Severe obesity in adolescence negatively impacts upon health and wellbeing. Lifestyle modifications do not usually achieve a sufficient degree or durability of weight loss to mitigate the risk of medical complications. In recent years, metabolic and bariatric surgery (MBS), already a well-established treatment for adults with severe obesity, has emerged as an option in adolescents. Controlled studies in this age group have demonstrated substantial and sustained weight loss, improvements in associated health parameters, and a safety profile surpassing that observed in adult patients. This review aims to present published data on the results of MBS in adolescents with a focus on long-term outcomes. Indications for bariatric surgery and aspects of timing in the young person's life are also presented, along with safety considerations and factors influencing patient selection for surgery. We conclude, predominantly from short- to medium-term outcomes data, that MBS is a safe and valuable therapeutic option for adolescents with severe obesity. Considering the poor health and social wellbeing prognosis in this group, MBS appears to be underutilized. The need for continued research, multiprofessional specialist provision, coherent contemporary clinical guidelines, and routine long-term follow-up in adolescents undergoing MBS is highlighted.

摘要

青少年重度肥胖对健康和幸福感有负面影响。生活方式的改变通常无法达到足够的减重程度或持久性,无法降低医疗并发症的风险。近年来,代谢和减重手术(MBS)已成为治疗严重肥胖成年患者的成熟治疗方法,也成为青少年患者的一种选择。在该年龄段进行的对照研究表明,MBS 可显著且持续地减轻体重,改善相关健康参数,且安全性优于成年患者。本综述旨在介绍有关 MBS 在青少年中的结果的已发表数据,重点关注长期结果。本文还介绍了青少年接受减重手术的适应证和手术时机,以及安全性考虑因素和影响手术患者选择的因素。我们的结论主要基于短期至中期结果数据,即 MBS 是治疗严重肥胖青少年的一种安全且有价值的治疗选择。考虑到该人群健康状况和社会幸福感不佳的预后,MBS 的应用似乎不足。需要持续研究、多专业专家提供、连贯的当代临床指南以及对接受 MBS 的青少年进行常规长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40be/10438888/ba300e8afd72/dgad155f1.jpg

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