Analysis Of Efficacy And Safety Of Laparoscopic Sleeve Gastrectomy In Adolescent Obese Patients

Objective: Adolescents are at a critical stage of growth and development,and the harm caused by obesity is multifaceted.Obesity often lasts into adulthood,leading to type 2diabetes,hypertension,fatty liver,etc.Although bariatric and metabolic surgery has shown remarkable results in the treatment of obesity in adults,there is no consensus across regions and countries on whether this radical treatment can be safely used in adolescents.China has the highest number of obese adolescents in the world,and is plagued by obesity and its complications.However,few relevant studies have been carried out,so this study mainly analyzes the short-term efficacy and safety of laparoscopic sleeve gastrectomy(LSG)in obese adolescents.Method:A retrospective analysis was performed on 50 adolescent obese patients who underwent LSG in the Second Affiliated Hospital of Anhui Medical University from January 2021 to June 2022.The body weight,BMI,waist circumference,hip circumference,glucose metabolism,lipid metabolism,uric acid metabolism and surgical safety evaluation indexes were collected before and 1,3 and 6 months after surgery.Results: A total of 50 obese adolescents were included in this study.The mean preoperative body weight was 128.15±14.86 kg,BMI was 44.52±8.32 kg/m~2,waist circumference was 128.27 ± 9.55 cm,and hip circumference was 121.12 ± 11.26 cm.Body weight(114.52±12.73 kg,100.84±11.79 kg,92.56±8.41 kg),BMI(34.61±6.89kg/m~2,29.17± 6.01 kg/m~2,28.26±5.04 kg/m~2)at 1,3 and 6 months after operation;Waist circumference(120.54± 10.13 cm,111.01± 9.62 cm,104.27± 8.34cm)and hip circumference(118.53± 10.07 cm,109.36± 8.36 cm,104.05± 7.12cm)were significantly lower than those before operation.The difference was statistically significant(P < 0.05).EWL% was 24.12±17.69 %,50.09±17.81 % and 64.31±18.03 % at 1,3 and 6 months after surgery,respectively.At the end of follow-up,EWL% of all obese adolescents was more than 30%,and the highest was 101%.At 6 months after operation,the related glucose metabolism indexes FBG,FINS,HbA1 c,and lipid metabolism indexes TG,HDL-C,and UA were significantly improved when compared with those before operation(P < 0.05).Obesity complications such as type 2 diabetes mellitus,hypertension,fatty liver,obstructive sleep apnea were relieved and improved.All 50 cases of LSG in this study were performed under laparoscopy,and the operation went smoothly.There was no conversion to open surgery or death during the operation,and there was no leakage,bleeding or stenosis after operation.Conclusion: LSG is an effective treatment for obese adolescents with high surgical safety and low incidence of postoperative complications.The majority of patients achieved satisfactory weight loss after LSG,and the related abnormal glucose metabolism,lipid metabolism,and uric acid metabolism were also significantly improved.Obesity comorbidities such as type 2 diabetes mellitus,hypertension,fatty liver,and obstructive sleep apnea were relieved or cured.