Abstract：
The American Society of Metabolic and Bariatric Surgery (ASMBS) and the American Academy of Pediatrics (AAP) recommend bariatric surgery as a treatment option for severe obesity. Bariatric surgery results in weight loss and improves obesity-related comorbidities. After surgery, adolescents and young adults require close observation and interdisciplinary care to help optimize weight loss, minimize nutrient deficiencies, address mental or physical health complications, and ensure a smooth transition to adult care. Yet, the extant literature on adherence and transition of care in bariatric programs is limited. Using 3 case studies from 2 bariatric programs, one on retention and 2 on transition of care, this paper highlights learning opportunities for care delivery after bariatric surgery. A quality improvement framework and an embedded electronic medical health registry can improve retention rates within a bariatric program. In addition, implementing a workflow ensures standardization of care; however, a key challenge is inadequate staffing. The programs established a transition of care policy and protocol by incorporating several of the Six Core Elements, a recognized guide for ensuring a safe and appropriate transfer from pediatric to adult care. Several research gaps remain, and further work is needed to determine and standardize best practices for adolescent bariatric surgery.
摘要：
美国代谢和减肥外科学会（ASMBS）和美国儿科学会（AAP）推荐减肥手术作为严重肥胖的治疗选择。减肥手术导致体重减轻并改善与肥胖相关的合并症。手术后,青少年和年轻人需要密切观察和跨学科护理，以帮助优化减肥，尽量减少营养缺乏，解决精神或身体健康并发症，并确保向成人护理的平稳过渡。然而，关于减重治疗方案中治疗依从性和过渡的现有文献有限.使用来自2个减肥项目的3个案例研究，一个关于保留，两个关于护理过渡，本文重点介绍了减肥手术后护理交付的学习机会.质量改进框架和嵌入式电子医疗健康注册表可以提高减肥计划中的保留率。此外,实施工作流程可确保护理标准化；然而，一个关键挑战是人员配备不足。这些计划通过纳入六个核心要素中的几个，建立了护理政策和协议的过渡，一个公认的指南，以确保安全和适当地从儿科转移到成人护理。仍然存在一些研究空白，需要进一步的工作来确定和标准化青少年减肥手术的最佳做法。
