ABSTRACT
Objective:
To analyze the clinical characteristics of obese
adolescents undergoing metabolic and
bariatric surgery for the purpose to guide
clinical decision-making and practice of metabolic and
bariatric surgery in
adolescents.
Methods:
The perioperative clinical profile of 123
adolescent patients under the age of 21 years
who underwent metabolic and
bariatric surgery in
Beijing Friendship Hospital,
Capital Medical
University from 2018 to 2021 were extracted, and compared their clinical data with the overall data of 6807
patients in the 2021 GC-MBD
Annual Report. Analyzed the clinical characteristics of
adolescent weight loss metabolic surgery patients from multiple aspects such as preoperative
complications, surgical
methods, surgical outcomes, and follow-up.
Statistical analysis was conducted using SPSS25.0
software.
Results:
Among
adolescent bariatric surgery patients, the proportion of
female patients (74.0%) was higher than that of
male patients (26.0%). Except for the
incidence of
polycystic ovary syndrome (31.9%), which was higher than the overall rate, the proportion of other related
diseases or symptoms was low and usually mild. The changes of systolic
blood pressure ( Z=-5.73, P<0.001),
body weight ( Z=-5.69, P<0.001), umbilical
abdominal circumference ( Z=-2.40, P=0.017),
glycosylated hemoglobin ( Z=-5.23, P<0.001),
fasting insulin ( Z=-2.95, P<0.003),
fasting C-peptide ( Z=-4.59, P<0.001),
triglyceride ( Z=-2.75, P=0.006) at 3 months after operation were statistically significant compared with those before operation. The changes of systolic
blood pressure ( Z=-3.42, P=0.001),
body weight ( Z=-5.14, P<0.001), umbilical
abdominal circumference ( Z=-2.86, P=0.004) and
glycosylated hemoglobin ( Z=-2.67, P<0.008),
fasting C-peptide ( Z=-2.09, P=0.037),
high-density lipoprotein ( Z=-2.08, P=0.038) at 6 months after operation were statistically significant compared with those before operation.
Conclusions:
The outcomes of
bariatric surgery in obese
adolescents are
similar to those in
adults. The indications and timing of
bariatric surgery need to be further explored. In view of the high proportion of
females, poor
self-management ability and low follow-up
compliance of
adolescent patients, it is urgent to construct a full-cycle care model suitable for
adolescent patients with
bariatric surgery to improve their
self-management ability, follow-up
compliance and long-term clinical outcomes.