Bariatric Surgery in Youth

Mirensky, Tamar L.

doi:10.1016/j.ecl.2016.02.003

Cited by 5 publications

(5 citation statements)

References 76 publications

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“…In the adult population, bariatric surgery is the most effective treatment modality for obesity and its comorbidities 132. In adolescence, considerable evidence is available to suggest a clinical effect of bariatric surgery in carefully selected candidates 133–135.…”

Section: Management Challengesmentioning

confidence: 99%

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Ng¹

2016

AHMT

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Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN) was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research.

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Section: Management Challengesmentioning

confidence: 99%

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Ng¹

2016

AHMT

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“…Moreover, the nutritional assessment is important to detect the baseline micronutrient deficiency, which is common in the pediatric population and may have an adverse consequence on the composite outcome. [ 38 ] An extension of the nutritional panel has been recommended to include thiamin (B1), vitamin B12, and B6, calcium, parathyroid hormone (PTH), alkaline phosphatase, vitamins A, D, E, and K, phosphorus, magnesium, copper, and zinc. [ 16 39 ]…”

Section: Preoperative Assessment Of the Pediatric Populationmentioning

confidence: 99%

“…Many obese children suffer from a wide spectrum of cardiovascular comorbidities ranging from hypertension (HTN) to arrhythmia. [ 38 ] Schlottmann et al . [ 40 ] have demonstrated that properly controlling the associated cardiac comorbidities is essential for proper postoperative outcomes.…”

Section: Preoperative Assessment Of the Pediatric Populationmentioning

confidence: 99%

Pediatric obesity and anesthetic challenges of metabolic surgery

Hashim

Sedky²,

Masood

et al. 2022

Saudi Journal of Anaesthesia

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Obesity in the pediatric population is considered a growing problem. It is likely that there will be a significant impact related to obesity on the health of future generations. Obesity has increased the incidence of a spectrum of diseases ranging from microvascular complications over the retina and peripheral nerves to an increased incidence of cancer. We have conducted an electronic search in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases targeting studies published between 2000 till 2019. Several modalities have shown a wide spectrum of the effectiveness of weight control among adolescents. Despite achieving short-term success among obese adolescents, maintaining such change is challenging. The emergence of metabolic or bariatric surgeries has opened the door for long-term control over weight gain with considerable remission of unfavorable metabolic mediated or modulated effects associated with obesity such as diabetes mellitus and hypertension. The most commonly practiced metabolic surgery among adolescents is sleeve gastrectomy which is associated with comparable weight and metabolic control and a lesser risk of complication. Anesthesia is considered a major challenge among the pediatric population, especially those with significant obesity. Preoperative evaluation is always warranted to exclude and manage different associated comorbidities. The anesthetic challenges associated with pediatric obesity begin with intubation. Maintenance and emergence from anesthesia along with postoperative antiemetics and analgesia can pose additional challenges. Managing the postoperative period is considered a cornerstone in the early detection and management of any postoperative complication. Especially those complications related to the metabolic and nutritional aspects of the bariatric surgery. Finally, despite being a valuable option in managing obesity, bariatric surgery in adolescents comes with significant anesthetic challenges that need to be consistently evaluated and managed.

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“…39 Children with severe obesity often suffer from numerous cardiovascular conditions, including hypertension, atherosclerosis, arrhythmias, diastolic dysfunction, and elevated cardiac work-load. 4,40 Controlling these comorbidities preoperatively is a key component of ensuring optimal surgical outcomes. 41 Thus, a thorough preoperative cardiac evaluation, which includes a medical history, physical examination, and a 12-lead electrocardiogram, should be obtained.…”

Section: Cardiacmentioning

confidence: 99%

Preoperative considerations for the pediatric patient undergoing metabolic and bariatric surgery

Pratt

Roque

Valera

et al. 2020

Seminars in Pediatric Surgery

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To ensure successful outcomes in pediatric patients with severe obesity who undergo metabolic and bariatric surgery (MBS), a number of pre-operative patient management options should be considered. This manuscript will review the indications and contraindications of MBS and special considerations for youth who might benefit from MBS. The treatment team conducts a thorough pre-operative evaluation, assessing risks and benefits of surgical intervention, and prepares patients and families to be successful with MBS by providing education about the surgical intervention and lifestyle changes that will be necessary. This article reviews the pre-operative considerations for adolescents with severe obesity who are being considered for MBS, based upon recent clinical practice guidelines.

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Bariatric Surgery in Youth

Cited by 5 publications

References 76 publications

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Pediatric obesity and anesthetic challenges of metabolic surgery

Preoperative considerations for the pediatric patient undergoing metabolic and bariatric surgery

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