OBESITY SURGERY IN CHILDREN
OBESITY SURGERY IN CHILDREN
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DOI：
10.1381/096089295765557647
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发表时间：
1995-08-01
期刊：
影响因子：
2.9
通讯作者：
BREAUX, CW
中科院分区：
文献类型：
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作者：
BREAUX, CW
背景：关于病态肥胖儿童的减肥手术的文章很少。然而，患有临床严重肥胖症的儿童也遭受社会接受度差和无法参加体育或其他生活活动。自1983年以来，作者对22例8 ~ 18岁的儿童进行了垂直带状胃成形术（VBG）、Roux-en-Y胃旁路术（RYGBP）或胆胰分流术（BPD）。手术方法为VBG-5; RYGBP-14;和BPD-4。无手术死亡、感染或其他严重的即刻并发症。睡眠呼吸暂停患者的体重指数（BMI）从术前的平均67.8降至平均随访32个月时的46.5 kg/m2。同样，无睡眠呼吸暂停患者的BMI从术前的56.4降至平均随访50个月时的35.5 kg/m2。所有患有睡眠呼吸暂停的患者都通过适当的体重减轻解决了这种情况。此外，这些患者能够在学校保持清醒，并取得更好的成绩。术后并发症包括3例BPD患者的蛋白质缺乏，维生素A和D缺乏、叶酸缺乏、胆结石、肾结石、术后喉水肿和切口疝各1例。有两人死亡;一个在术后15个月，一个在术后3.5年。结论：临床上严重肥胖的儿童可以安全地接受减肥手术，通常提供给成年人。此外，大多数患者都有明显的体重下降。睡眠呼吸暂停综合征的症状有哪些？补充足够的维生素、矿物质和微量元素可以最大限度地减少并发症。长期结果尚不清楚。
Background: There have been few articles about bariatric surgery for morbidly obese children. Nevertheless, children who suffer clinically severe obesity also suffer poor social acceptance and an inability to participate in sports or other life activities. Since 1983 the author has performed vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGBP), or biliopancreatic diversion (BPD) on 22 children, ages 8 - 18 years.Methods: This was a retrospective review of 22 children, 11 with sleep apnea and 11 without sleep apnea, There were nine males and 13 females. The procedures were VBG-5; RYGBP-14; and BPD-4.Results: There were no operative deaths, infections, or other serious immediate complications, Body mass index (BMI) In those with sleep apnea decreased from a mean of 67.8 preoperatively to 46.5 kg/m(2) at an average followup of 32 months, Likewise, for those without sleep apnea, BMI decreased from 56.4 preoperatively to 35.5 kg/m(2) at an average follow-up of 50 months. All patients with sleep apnea had this condition resolve with adequate weight loss. Furthermore, these patients have been able to stay awake in school and have made better grades. Postoperative complications included protein deficiency in three BPD patients, and Vitamin A and D deficiency, folic acid deficiency, gallstones, kidney stones, postoperative laryngeal edema, and incisional hernia in one patient each. There were two late deaths; one at 15 months and one at 3.5 years postoperatively.Conclusions: Clinically severely obese children can safely undergo bariatric operations usually offered to adults. Furthermore, most patients have sustained significant weight toss. Those patients with sleep apnea have had resolution of their sleep apnea. Complications can be minimized with adequate vitamin, mineral, and trace element supplementation. Long-term results are not yet known.