[Bariatric surgery for morbid obesity in childhood and adolescence: where do we stand in 2008?].
Bariatric surgery for children and adolescents with morbid obesity has not gained broad acceptance in Germany yet.Nevertheless, these children often fail to reduce weight despite intensive weight loss programmes and suffer from an associate metabolic syndrome, just like adults. Thus, bariatric surgery may be a favourable option. The present article compares national and international experiences concerning guidelines, surgical procedures, and results. It becomes obvious that Germany has neither specific guidelines for children and adolescents nor a central registry. Internationally,the recommendation from the Bariatric Scientific Collaborative Group (BSCG) should be taken as the standard. As in adults, most surgeons perform Roux-Y gastric bypass or gastric banding. Additionally, sleeve gastrectomy is gaining some popularity. These procedures are performed in designated pediatric centres especially in the US. Their success and complication rates are similar to those found in adults.The overall long-term consequences, however, remain unclear.Thus, for bariatric surgery in children and adolescents it may be concluded that a) these patients should be treated in designated centres that offer the full range of therapeutic options,b) specific guidelines should be established, especially in Germany, and c) a long-term postoperative study of all patients is necessary to collect all data and refine the techniques used.
Till
Holger
H
Klinik und Poliklinik fur Kinderchirurgie, Universitat Leipzig, Deutschland. holger.till@uniklinik-leipzig.de
Bluher
Susann
S
Kiess
Wiel
W
D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods; D002648:Child; D005743:Gastrectomy; D015390:Gastric Bypass; D015391:Gastroplasty; D005858:Germany; D006801:Humans; D024821:Metabolic Syndrome / Q000209:etiology; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss