Metabolic surgery in severely obese adolescents: which technique provides the best benefits?
Cirugía metabólica en adolescents con obesidad severa: ¿Qué técnica provee mejores beneficios?
Daniela Osorno Avendaño, María Camilia Paez Silva, Ana María Londoño Fonseca, Jose Antonio Vergara Torrente, Carolina Rodríguez Ocampo, Franklin Kevin Ruiz-Gutierrez, Yelson Picón
Abstract
Obesity is a public health and global health problem due to the disease burden it generates across all age groups, as well as being a pandemic due to its high prevalence worldwide. Bariatric surgery has traditionally been described as an aggressive option in the adolescent population. However, as the evolution of these patients over time and the improvement in health outcomes have been rigorously analyzed, it is positioned as an effective and safe intervention. Recently, novel high-quality evidence has emerged, sparking international scientific discourse on which techniques provide the most benefits and are safer in bariatric surgery for adolescents with severe obesity. Then, the aim of this review was to analyze the most recent clinical evidence, based on study designs, regarding clinical and surgical outcomes obtained by surgical techniques used during bariatric surgery in the management of severe obesity in adolescents. After the literature review, it was identified that surgical resolution for severe obesity in adolescents is effective and safe, with better benefits observed when using Roux-en-Y gastric bypass. There is a similar frequency of adverse events compared to sleeve gastrectomy and gastric banding. Micronutrient deficiency is the primary adverse event, which is potentially preventable and treatable.
Keywords
Resumen
La obesidad es un problema de salud pública y global debido a la carga de enfermedad que genera en todos los grupos de edad, además de ser una pandemia por su alta prevalencia a nivel mundial. La cirugía bariátrica ha sido tradicionalmente considerada como una opción agresiva en la población adolescente. Sin embargo, a medida que la evolución de estos pacientes a lo largo del tiempo y la mejora en los resultados de salud han sido rigurosamente analizados, se posiciona como una intervención eficaz y segura. Recientemente, han surgido pruebas novedosas de alta calidad, generando un discurso científico internacional sobre qué técnicas proporcionan mayores beneficios y son más seguras en la cirugía bariátrica para adolescentes con obesidad severa. Por lo tanto, el objetivo de esta revisión fue analizar las evidencias clínicas más recientes, basadas en diseños de estudio, en relación con los resultados clínicos y quirúrgicos obtenidos por las técnicas quirúrgicas utilizadas durante la cirugía bariátrica en el manejo de la obesidad severa en adolescentes. Después de la revisión de la literatura, se identificó que la resolución quirúrgica para la obesidad severa en adolescentes es efectiva y segura, con mejores beneficios observados al utilizar el bypass gástrico en Y de Roux. Existe una frecuencia similar de eventos adversos en comparación con la gastrectomía en manga y la banda gástrica. La deficiencia de micronutrientes es el principal evento adverso, el cual es potencialmente prevenible y tratable.
Palabras clave
References
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Submitted date:
06/25/2024
Reviewed date:
09/01/2024
Accepted date:
09/21/2024
Publication date:
10/02/2024
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