Translated material
The Ministry of Health may allow stomach reduction surgery for obese children
The Russian Ministry of Health has proposed recognizing gastric resection, an operation in which part of an organ is removed, as the standard of medical care for obese children. At the same time, government funding for such operations is provided only for adult patients. Kommersant writes about this.
It is reported that the department has developed a draft updated standard of medical care for children suffering from obesity, “with the aim of improving” the diagnosis, treatment and follow-up of this disease. According to the current version of the document, obese children undergo an ultrasound of the abdominal organs, an MRI of the brain, and the percentage of water, muscle and fat tissue is determined using a bioimpedance meter.
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In the proposed version of the updated standard of medical care, the department for the first time included surgical, endoscopic and endovascular treatment methods, which included gastric resection, gastric bypass and banding. In addition, children's visits to a geneticist, neurologist and pediatric endocrinologist included examinations by a nutritionist and otolaryngologist. At the same time, the authors of the document excluded a set of exercises (physical therapy) from preventive treatment methods. It is noted that the discussion of the project will last until December 17.
Candidate of Medical Sciences, surgeon Alexander Neimark argues that gastric resection and gastric bypass are “highly effective and are recognized as the gold standard in the treatment of severe obesity.” According to him, such operations are indicated for children only upon reaching puberty, if the body mass index is greater than or equal to 35 and in the presence of type II diabetes mellitus, when previous treatment methods have been ineffective.
The surgeon noted that gastric reduction operations are not an innovation, but their implementation may be difficult due to the lack of an established tariff in the state guarantee program.
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“That is, even if the method is prescribed in the standard, you will not be able to get free help, since the state provides funding for such operations only after reaching 18 years of age,” he said.
The publication notes that Russian doctors are increasingly forced to prescribe bariatric surgery to overweight patients. According to the All-Russian Bariatric Registry, in 2020, 3,292 surgical interventions were performed in the stomach and intestines, and in 2023, their number increased to 8,955. For patients with type II diabetes, about 600 quotas are allocated annually, while for others, the cost of the operation varies from 200 up to 400 thousand rubles.
According to WHO, in 2022, more than 390 million children and adolescents aged 5 to 19 years were overweight worldwide. Of these, 160 million were reported to be obese.
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