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Nutrition clinique et métabolisme
Volume 28, n° 2
pages 90-94 (mai 2014)
Doi : 10.1016/j.nupar.2013.11.001
Received : 27 May 2013 ;  accepted : 7 November 2013
Chirurgie bariatrique : enjeux et limites chez l’adolescent obèse
Bariatric surgery: Major issues and limits in obese adolescent
 

Béatrice Dubern
 Nutrition et gastroentérologie pédiatriques, hôpital Armand-Trousseau, 26, avenue du Dr Arnold-Netter, 75012 Paris, France 

Résumé

L’augmentation des formes extrêmes d’obésité chez l’adolescent et les résultats décevants des prises en charge classiques amènent actuellement les pédiatres à envisager la chirurgie bariatrique comme option thérapeutique. La prudence est cependant de mise en raison des particularités de cette tranche d’âge. L’adolescence est en effet caractérisée par des besoins nutritionnels spécifiques mais aussi des modifications de l’image corporelle sur lesquels la chirurgie pourrait avoir un effet négatif. Selon les recommandations internationales, tout adolescent obèse faisant la demande d’une chirurgie bariatrique doit faire l’objet d’une évaluation complète avec prise en charge globale (médicale, psychologique et diététique) pendant au moins 6 mois. L’indication est alors discutée au cas par cas par des équipes multidisciplinaires aguerries et expertes (médecins, chirurgiens, psychologues, anesthésistes, diététiciens). À ce jour, le type de chirurgie (anneau gastrique ou gastrectomie longitudinale ou court-circuit gastrique) reste toujours largement discuté même si le court-circuit gastrique doit probablement être privilégié.

The full text of this article is available in PDF format.
Abstract

Due to the increased frequency of extreme obesity in adolescents and the inefficiency of usual treatments, bariatric surgery is now largely discussed as novel therapeutic option. However, it is important to be cautious due the specificity of this age since adolescence is characterized by specific nutritional requirements and important modifications of body image. According to international recommendations, it is critically important that obese adolescents have meticulous follow-up before bariatric surgery with global evaluation (medical, psychological, nutritional) during at least 6 months. Indication of such surgery is then discussed case to case with multidisciplinary expert team (doctors, surgeons, psychologists, dietitians, anesthesiologists). Until now, the type of surgery (adjustable gastric banding, sleeve gastrectomy or Roux-en-Y gastric bypass) is still largely discussed even if Roux-en-Y gastric bypass should be the better option due to its higher efficacy.

The full text of this article is available in PDF format.

Mots clés : Obésité massive, Adolescence, Chirurgie bariatrique

Keywords : Obesity, Adolescence, Bariatric surgery




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