可以用微創技術安全地進行青少年減重手術


  May 26, 2008(加州舊金山) – 一項發表於2008年消化道疾病週中的初步結果顯示,一種經由口腔的微創減重手術方式看來可以安全、幾乎無痛的讓一些篩選過的病態肥胖青少年減重。
  
  de Clinicas Caracas醫院胃腸科主任Roberto Fogel醫師在發表時表示,初步結果顯示,腔內垂直胃鏡(EVG)是安全的,但在這項技術被認為實際可行之前,還需要長期追蹤。
  
  藉由EVG,外科醫師縫合胃壁前方和後方,以減少胃容積。
  
  這項前驅研究包括年紀在14-17歲之間的10名女孩和2名男孩,開始時,平均身體質量指數(BMI)為38.1kg/m2 (±7.7),開始時平均體重範圍為80kg-158kg。
  
  Fogel醫師使用全身麻醉進行手術,手術時間約需要 40分鐘,病患可以在術後1小時下床行動且返家,病患指出疼痛程度輕微且沒有疤痕;此外,沒有手術造成的併發症。
  
  在術後1、3、6個月進行術後追蹤評估,初步結果測量過重體重減輕之部分,根據青少年成長的前50百分比作為計算依據。
  
  Fogel 醫師報告指出,全部病患體重都減輕了,在1個月時平均減少 17.9% (± 5.9%),在3個月時平均減少38.6% (± 16.3%),在6個月時平均減少62.2% (± 15.0%);令人驚訝的是,減少了過量體重的80%,我們的病患並不會感到飢餓。
  
  這項經口手術之後6個月,平均BMI 為27.8 kg/m2 (± 5.8)。
  
  會議主持人、南卡羅來納醫學大學消化道疾病中心醫學教授Mark DeLegge醫師在Fogel醫師發表之後表示,這種程度的減重是驚人的。
  
  DeLegge醫師表示,我們必須看看病患是否可以維持減重,許多成人在手術之後會復胖,問題不在於技術或手術,而是病患。
  
  Fogel醫師表示,這些病患經過篩選,病患必須瞭解他們需要改變生活型態,包括飲食和運動;一如接受減重手術的成人,胃部可能再度被撐大,年輕病患的胃部看似比成人更有延展性。
  
  Fogel醫師表示沒有相關資金上的往來, DeLegge醫師是Nestle Home Care Products的顧問,但是該公司和Fogel醫師的研究沒有設備或技術上的資金衝突。
  
  2008年消化道疾病週(DDW) :摘要 243。發表於2008年5月19日。

Adolescent Bariatric Surgery C

By Martha Kerr
Medscape Medical News

May 26, 2008 (San Diego, California) – A per?oral, minimally invasive approach to bariatric surgery appears to be a safe, virtually painless approach to weight loss in highly selected morbidly obese adolescents, early results presented here at Digestive Disease Week 2008 indicate.

Preliminary results show that endoluminal vertical gastroscopy (EVG) is safe, but before the technique can be considered truly feasible, longer follow-up is needed, Dr. Roberto Fogel, MD, chief of the department of gastroenterology at the Hospital de Clinicas Caracas, in Venezuela, cautioned when he presented the preliminary results.

In EVG, the surgeon sutures the anterior and posterior walls of the stomach together to reduce the volume of the stomach.

The pilot study involved 10 girls and 2 boys between the ages of 14 and 17 years. At baseline, average body mass index (BMI) was 38.1?kg/m2 (±7.7) and average baseline weight range was 80?kg to 158?kg.

Dr. Fogel performed the procedure using general anesthesia. It took approximately 40 minutes to complete. Patients were ambulatory and discharged home an hour afterward. Patients reported minimal pain and there was no scarring. There were no procedural complications, he announced.

Postoperative follow-up assessments were conducted at 1, 3 and 6 months. The primary outcome measure was excess weight loss, with calculations based on the 50th percentile for adolescent growth.

"All patients lost weight," Dr. Fogel reported, with a mean weight loss of 17.9% (± 5.9%) at 1 month, 38.6% (± 16.3%) at 3 months, and 62.2% (± 15.0%) at 6 months. "The incredible thing is that patients have gone to almost 80% of excess weight loss. Our patients just do not feel hungry," he commented.

Six months after per?oral bariatric surgery, mean BMI was 27.8?kg/m2 (± 5.8).

"This degree of weight loss is phenomenal," session moderator Mark DeLegge, MD, professor of medicine in the Digestive Disease Center of the Medical University of South Carolina, in Charleston, commented after Dr. Fogel's presentation.

"We'll have to see if patients can maintain this weight loss. A lot of adults are starting to regain the weight they lost after surgery," Dr. DeLegge said. "The problem is not the technique and not the [procedure], but the patient."

Dr. Fogel cautioned that "these patients were highly selected.... Patients have to realize that they need to change their lives," with diet and exercise as well as surgery. As with adults who undergo bariatric surgery, the stomach can get stretched out again, and younger patients seem to have stomachs that can stretch more than adults."

Dr. Fogel has disclosed no relevant financial relationships. Dr. DeLegge is a consultant for Nestle Home Care Products, but has no financial conflicts with the devices or techniques used in Dr. Fogel's study.

Digestive Disease Week (DDW) 2008: Abstract 243. Presented May 19, 2008.

    
相關報導
回顧發現:肥胖基因對減重無影響
2016/9/30 下午 04:58:33
維他命D增強年長女性的減重效果
2015/7/13 上午 09:22:45
肥胖治療不只需要調整生活型態
2015/3/3 下午 02:28:48

上一頁
   1   2   3   4   5   6   7   8   9   10  




回上一頁