Effizienz und Anwendbarkeit der Sleeve Gastrektomie bei jüngeren Patienten im Vergleich zu älteren. Multizentrische Propensity-Score-Matching-Analyse.

Zusammenfassung

Ziel In dieser Arbeit werden die Resultate der Sleeve Gastrektomie (SG) von Jugendlichen und älteren Patienten verglichen.

Methodik Vom 01.01.2005 bis 31.12.2020 wurden 317 Jugendliche (≤21 Jahre) im prospektiven, multizentrischen German Bariatric Surgery Registry erfasst. Ihre Daten werden mit 3721 Patienten (30–40 Jahre) gegenübergestellt. Fokus liegt auf der Veränderung von BMI, T2DM, aHTN, OSAS, GERD und perioperativen Ereignissen. Die Parameter wurden mittels Propensity-Score-Matching verglichen.

Ergebnisse Ein Matching erfolgte für 273 (86,1%) Patienten. Es wurden keine signifikanten Unterschiede in der Remission von T2DM, OSAS oder GERD beobachtet. Die Remission der aHTN zeigte signifikante Vorteile zugunsten jugendlicher Patienten (p<5%). Für die perioperativen Ereignissen und BMI-Reduktion fand sich kein signifikanter Unterschied.

Schlussfolgerung Die SG ist ein sicheres, wirksames Verfahren. Es führt altersunabhängig zu einer guten Gewichtsabnahme und Verbesserung der Komorbiditäten. Da die SG mit diversen Komplikationen verbunden sein kann, sollte die Indikation bei Jugendlichen von einem interdisziplinären Team gestellt werden. Die Nachsorge sollte langfristig interdisziplinär erfolgen.

Abstract

Purpose This multicentric study contrasts the effects of primary sleeve gastrectomy (SG) on younger and older patients regarding the development of comorbidities, weight loss, and perioperative course.

Methods Between 01.01.2005 to 31.12.2020 317 adolescents (≤21 years) and 3,721 older adults (age 30–40) who had undergone SG were prospectively in the multicenter German Bariatric Surgery Registry registered. Focus were perioperative events, change of BMI, T2DM, hypertension, sleep apnea, and GERD one year after operation. To compare outcomes a propensity score matching analysis was performed.

Results Matching was achieved for 273 (86.1%) patients. Remission rates for T2DM, OSAS and GERD were not significant different. The remission of hypertension has shown a statistically significant difference (p<5%) with benefits for adolescents. BMI and perioperative events were without a statistically significant advantage.

Conclusion SG is reliable, effective procedures. SG achieves good results in weight loss and the treatment of obesity-related diseases in all age groups. However, SG carries risks. Therefore, the decision to perform SG in adolescents should be discussed by a multidisciplinary team. A long-term interdisciplinary treatment is neccesary.

Schlüsselwörter

Sleeve Gastrektomie - Adipositaschirurgie in Kindern und Jugendlichen - perioperative Ereignisse - Komorbiditäten

Key words

sleeve gastrectomy - bariatric surgery in children and adolescents - perioperative outcomes - comorbidities

Publication History

Article published online:
04 September 2023

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