Jimu news reporter Yan Wen
Correspondent Liu Yu
A month ago, when Xiaotong (pseudonym), a "super heavyweight" child, entered the gastrointestinal surgery (weight loss and metabolic surgery) office of the East Hospital of Wuhan University People's Hospital in a wheelchair, the well-informed doctors were shocked: he was only 16 years old, and his weight reached a staggering 360 pounds. Fortunately, after successful weight loss surgery and comprehensive intervention, Xiaotong had successfully lost 40 pounds when he was discharged from the hospital a few days ago.
Doctors say bariatric surgery is not once and for all. It is hoped that through standardized comprehensive intervention, coupled with the persistence of children and the efforts of parents, we will strive to lose 200 pounds or more in two years.
At the age of 6, he "had a big appetite" and never returned on the way to becoming fat
Born in 2006, Xiao Tong just celebrated his 16th birthday and has weighed more than 360 pounds.
As the saying goes, you can't eat a fat man in one bite, and Xiaotong's current physique is also "eating out little by little". According to his father, at first, Xiaotong was no different from other children, but when he was about 6 years old, he had a big appetite, especially fond of fragrant delicacies such as fried chicken legs, and his body began to gain weight rapidly. At the age of 9, he weighed more than 120 pounds, far exceeding his peers. Since then, the family began to limit Xiaotong's food intake, and also took him to participate in sports activities to try to lose weight on his own, but all failed.
Excessive obesity has brought many inconveniences to Xiaotong: not only do the clothes they wear need to be customized individually, but the usual range of activities is also greatly restricted, and Xiaotong is almost always at home except for school. After a little activity, I was out of breath, and I felt powerless to even climb the 2nd floor. After seeing that after entering puberty, Xiaotong was more like blowing air, and the family could no longer sit still, so they came to the Gastrointestinal Surgery Department (Weight Loss and Metabolic Surgery) of the East Hospital of Wuhan University People's Hospital (Hubei Provincial People's Hospital) for help.
Dr. Qu Bing, who received the treatment, conducted a comprehensive physical examination of Xiaotong and found that Xiaotong was 180cm tall, weighed 180.2kg, and had a BMI value of 55.6, which was severe obesity. The thick belly fat rests on the body, like a thick quilt, and the abdominal circumference reaches a staggering 160cm. Adult males with a abdominal circumference of more than 90 cm can confirm the diagnosis of central obesity.
Relying on wheelchairs to travel, obesity brings many diseases
Further examination also found that Xiaotong had a severe fatty liver, elevated aminotransferases, and impaired liver function, which had met the diagnostic criteria for non-alcoholic steatohepatitis. There are serious abnormalities in blood lipids, low-density lipoproteins, etc., combined with signs of central obesity, which doctors diagnose as metabolic syndrome.
In addition, the attentive Dr. Qu found that there were severe acanthosis nigricans in many wrinkles of Xiaotong's body, such as the neck, lower abdomen and bilateral groin area, which was a manifestation of insulin resistance. After investigation, it was found that the abnormal increase of insulin and C peptide in his body was many times, which confirmed that Xiaotong had abnormal insulin resistance and glucose tolerance, and if the weight was not controlled, it would soon develop into diabetes.
Because excessive obesity blocks the respiratory tract, Xiaotong often sleeps and wakes up, and for many years can only sleep on his stomach. Both knee joints are also overburdened and overly injured, and if you stand for a little longer, your hands and feet will be numb. Before being admitted to the hospital, Xiaotong had already relied on a wheelchair to travel.
Under the presidency of Professor Luo Jianfei, Director of gastrointestinal surgery of The East Hospital, the MDT team was formed in the Department of Pediatrics, The Department of Endocrinology, the Mental Health Center, the Department of Anesthesiology and the Intensive Care ICU of the East Hospital. Through multidisciplinary comprehensive diagnosis and treatment, Xiaotong was customized with weight loss recipes, cardiopulmonary exercises, mental health guidance, and comprehensive intervention treatment programs for metabolic syndrome, bariatric surgery.
Let the "big stomach" reduce the capacity, and lose 40 pounds in the 10 days after the operation
After active surgical preparations, On March 16, Xiaotong was pushed into the operating room. Overweight, he was carried to the operating table by 9 medical staff. Due to his severe sleep apnea syndrome (OSAHS) and hypopnea dysfunction, considering the difficulty of endotracheal intubation, the team of director Meng Qingtao of the Department of Anesthesiology and the head nurse Zhang Shi of the operating room carefully prepared to escort the operation.
Under the high-definition laparoscopy, Professor Luo Jianfei led the team to complete the laparoscopic gastric bypass surgery for 3 hours. During the operation, the doctor divides Xiaotong's "super large stomach" into two parts: the smaller upper part is connected to the small intestine as a channel for food to enter; the larger lower stomach and duodenum secrete digestive juices together, and as another channel to confluence in the small intestine, achieving the effect of both diversion and reduced absorption.
Under the meticulous care of the nursing team, Xiaotong was able to get out of bed freely on the third day after the operation. Under the guidance of the comprehensive intervention treatment plan, he had lost 40 pounds when he was discharged from the hospital on March 25.
But bariatric surgery is not "once and for all". Luo Jianfei said that if comprehensive intervention can be adhered to, the weight of the child after surgery will show a significant downward trend, and 50%-90% of the overweight weight will be lost after 1 year, that is, 60-100 kg of weight. According to the doctor's plan, Xiaotong will lose 200 pounds or more in the next 1 to 2 years to reach the ideal weight and maintain it. He pointed out that the treatment of childhood and adolescent obesity should take a comprehensive approach, including education to guide lifestyle changes, drug treatment, etc., and bariatric surgery should be used as a last resort in cases where other treatments are ineffective.