Different Surgical Modalities in Management of Childhood Obesity
Reda AbdelFattah ElmowafiBadran;
Abstract
Background: Obesity is a growing serious health problem in children andadolescents.TheManagementplanworldwideisa stepwise approach that involves lifestyle changes and bariatric surgery. Different surgical options are available for obese adolescents.Restrictiveoperations; AdjustableGastricBanding (AGB),andVertical-BandedGastroplasty (VBG).Mal-absorptive operations;Biliopancreatic Diversion (BPD)withorwithout Duodenal Switch(DS), andcombined;GastricBypass(RYGBP). Althoughallarevalidinadults,therehasbeencontroversyamong the scientific bodies to define the standard surgical treatment, because of the concerns surrounding bariatric surgery in this particularagegroup.
Methods:Thisisaprospectivestudy conductedatAinShams university hospitalin40obeseadolescentsallocatedequally into4 groupsandofferedrandomly AGB,VBG,RYGBPorBPD/DSand followed-upfor 1year, afterfailure ofconservative treatmentand legalizationhasdocumented.Eachpatient’sBMI wasabovethe99th percentile for age and sex. All patients had one or more comorbidities.
Results:Theaverageagewas15.3(13-18years),TheaverageBMI
was55.2±8.4Kg/m2,andExcessBodyWeight(EBW)was84.8±
22.6kg.Eachtypeofsurgeryhasinducedsignificantweightloss. The average EBW loss was 93.1±5.6, 78.5±14.6, 66.9±24.1, and
51.7±23.1kg forBPD,RYGBP.VBG,andAGB,respectively.BPD wasthemostpowerfulinreducingBody weightandresolutionof comorbidities , but with highercomplications rate.
Conclusions:RYGBPisthe surgicaltreatmentof choice for obese adolescents, becauseithassuperioroutcomestoVBGandAGB with acceptable complicationsrate,andcomparableweightlossto BPD/DS. BPDshouldbepreserved forpatientswithPrader-Willi Syndrome.
Keywords:Bariatric surgery, Weightlosssurgery,Childhoodand adolescents’obesity,Adolescents’bariatric surgery,Biliopancreatic diversion,Duodenalswitch,Gastric Bypass,Vertical-banded gastroplasty,Adjustablegastricbanding.
Methods:Thisisaprospectivestudy conductedatAinShams university hospitalin40obeseadolescentsallocatedequally into4 groupsandofferedrandomly AGB,VBG,RYGBPorBPD/DSand followed-upfor 1year, afterfailure ofconservative treatmentand legalizationhasdocumented.Eachpatient’sBMI wasabovethe99th percentile for age and sex. All patients had one or more comorbidities.
Results:Theaverageagewas15.3(13-18years),TheaverageBMI
was55.2±8.4Kg/m2,andExcessBodyWeight(EBW)was84.8±
22.6kg.Eachtypeofsurgeryhasinducedsignificantweightloss. The average EBW loss was 93.1±5.6, 78.5±14.6, 66.9±24.1, and
51.7±23.1kg forBPD,RYGBP.VBG,andAGB,respectively.BPD wasthemostpowerfulinreducingBody weightandresolutionof comorbidities , but with highercomplications rate.
Conclusions:RYGBPisthe surgicaltreatmentof choice for obese adolescents, becauseithassuperioroutcomestoVBGandAGB with acceptable complicationsrate,andcomparableweightlossto BPD/DS. BPDshouldbepreserved forpatientswithPrader-Willi Syndrome.
Keywords:Bariatric surgery, Weightlosssurgery,Childhoodand adolescents’obesity,Adolescents’bariatric surgery,Biliopancreatic diversion,Duodenalswitch,Gastric Bypass,Vertical-banded gastroplasty,Adjustablegastricbanding.
Other data
| Title | Different Surgical Modalities in Management of Childhood Obesity | Other Titles | الأنظمة الجراحية المختلفة لعلاج السمنة عند الاطفال | Authors | Reda AbdelFattah ElmowafiBadran | Issue Date | 2016 |
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