期刊
JOURNAL OF PEDIATRIC SURGERY
卷 41, 期 1, 页码 137-142出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2005.10.017
关键词
obesity; gastric bypass; bariatric; surgery; metabolic syndrome; adolescent; pediatric
资金
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R03DK068228] Funding Source: NIH RePORTER
- NIDDK NIH HHS [1R03DK068228] Funding Source: Medline
Background/Purpose: Little is known about the metabolic outcomes of adolescent bariatric surgery. We report changes in weight, metabolic profile, and types of complications seen in a multicenter cohort. Methods: One-year outcomes were included. For weight loss comparisons, a nonsurgical cohort (n 12) was used. The primary Outcome was weight change (n = 30) and secondary outcones were metabolic variables (n = 24) and complications (n = 36). Data were analyzed using signed rank or paired t tests. Results: Mean body mass index fell 37% (from 56.5 preoperatively to 35.8 kg/m(2); P < .001) in Surgical patients and 3% (from 47.2 to 46 kg/m(2);P = NS) in nonsurgical patients. Surgical patients showed significant improvements in triglycerides (-65 mg/dL), total cholesterol (-28 mg/dL), fasting blood glucose (-12 mg/dL), and fasting insulin (-21 mu M/mL). Improvement in high-density lipoprotein cholesterol (-3.9 mg/dL) and low-density lipoprotein cholesterol (-8.8 mg/dL) was not statistically significant. Sixty-one percent of surgical patients had no complications. Of 15 patients with complications, 9 had minor complications with no long-term sequelae, 4 had at least I moderate complication with sequelae for at least 1 month and 2 had at least 1 severe medical complication with long-term consequences (including beriberi and death). There were no perioperative deaths or other severe surgical complications in this series. Conclusions: postoperatively, adolescents lose significant weight and realize major metabolic improvements. The complication profile compares favorably to severely obese (body mass index > 40 kg/m(2)) adults; however, small sample size precludes calculation of complication rates. Although there are considerable risks of bariatric surgery, early experience suggests that risks are offset by health benefits. (c) 2006 Elsevier Inc. All rights reserved.
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