Calidad metodológica y de reporte de ensayos controlados aleatorizados sobre el impacto en desenlaces en salud de la cirugía bariátrica en adolescentes obesos: Estudio metodológico
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Objetivo: Evaluar la calidad metodológica y de reporte de los ensayos controlados aleatorizados (ECAs) que han estudiado el impacto de la cirugía bariátrica en los desenlaces de salud de adolescentes obesos.
Materiales y métodos: Se realizó un análisis metodológico de resultados obtenidos de las bases PubMed, Scopus, Web of Sciences y Scielo, hasta mayo de 2025. Dos revisores, de manera independiente, seleccionaron ECAs que incluyeran adolescentes sometidos a bypass gástrico, gastrectomía en manga o banda gástrica como intervenciones. Se utilizaron las listas de chequeo CONSORT 2025 (39 sub-ítems) y la herramienta Joanna Briggs Institute para ECAs (13 ítems).
Resultados: Se incluyeron tres ECAs publicados entre 2010 y 2024, con un total de 141 adolescentes (media de 47 por ensayo). El 100% de los estudios se registró prospectivamente y el 67% fueron multicéntricos. Todos mostraron superioridad quirúrgica en el control ponderal (pérdidas promedio de 12-35 kg) y en la remisión del síndrome metabólico (0-22% en controles vs 78-100% en intervenidos); el efecto sobre la función cognitiva global fue neutro (diferencia de medias de 0,4 IQ; IC 95%: -3,9 a 4,8). El promedio de cumplimiento de la lista de chequeo CONSORT fue del 71,8%. Para la calidad metodológica, la media de cumplimiento fue del 74% (10/13 ítems en dos estudios; 9/13 en uno).
Conclusiones: Aunque los estudios sobre cirugía bariátrica concluyen proveer beneficios en pérdida de peso y metabolismo en adolescentes, la evidencia se sustenta en un número limitado de estudios con brechas importantes de transparencia y control de sesgos quirúrgicos.
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