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【medical-news】肥胖青少年的外科新希望
New Surgical Hope for Obese Teens
By Lucy Williams, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire) -- From social teasing to health complications, obese adolescents have a tough road ahead. But recent research reveals stomach-banding surgery could offer new hope for teens who have exhausted other weight loss options.
"It would open a tremendous number of doors for the morbidly obese adolescent who can't lose weight via any other diet or exercise program," study author Evan Nadler, M.D., director of pediatric minimally invasive surgery at New York University School of Medicine in New York, told Ivanhoe. "We never advocate surgery as the first step, but unfortunately there are lots of children who just can't lose weight no matter what they do."
Childhood obesity is at epidemic proportions in the United States. More than 25 percent of American high school students are overweight or at-risk of being overweight. Diet and exercise can help some teens keep their weight in check, but most overweight adolescents become obese adults.
Gastric bypass surgery is the only FDA-approved surgical weight loss option for individuals younger than 18. Unfortunately, the procedure carries a mortality rate of at least 1 percent -- even in the hands of experienced surgeons.
Dr. Nadler said laparoscopic adjustable gastric banding, or lap banding, could be a safer, longer-lasting weight loss treatment for teens. The gastric band, or lap band, is an inflatable silicon ring fitted around the upper portion of the stomach, creating a smaller stomach. By making patients feel full sooner, it helps patients limit their food intake. A doctor can make the band tighter or looser at the patient's request.
In a recent study, researchers followed 53 morbidly obese adolescents ages 13 to 17 who underwent lap band surgery. The average weight loss for each patient was about 50 percent of excess weight at 12 and 18 months following surgery. This figure is comparable to weight loss following gastric bypass surgery.
Individuals are considered morbidly obese when their body mass index is 40 or higher.
"Currently, a morbidly obese teenager who suffers from diabetes only has one surgical option for weight loss, which is gastric bypass," he said. "This study shows there is potential for another option, which is a much safer option and, at least in our hands, is an equally affective option as the gastric bypass."
Dr. Nadler said patients with the band are less likely to regain weight because the band is adjustable. If a patient gains weight, a doctor can tighten the band and decrease the size of the stomach.
Further research is needed to determine the long-term safety and efficacy of gastric band surgery.
"The FDA has not currently approved the band for patients under the age of 18, and this is the first study to suggest the band is effective in that age group," Dr. Nadler said. "Hopefully others will have similar experience and there will be more data available for the FDA so eventually it will be approved so we can offer this ... life-altering operation to a group of adolescents who otherwise have no real solution to their problem."
This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
SOURCE: Ivanhoe interview with Evan P. Nadler, M.D., New York University School of Medicine; Journal of Pediatric Surgery, 2007;42:137-142
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作者:admin@医学,生命科学 2011-02-27 17:11
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