Mid-term follow-up after laparoscopic sleeve gastrectomy in obese adolescents.

BACKGROUND Laparoscopic sleeve gastrectomy (LSG) is gaining credibility as a simple and efficient bariatric procedure with low surgical risk. Since surgical treatment for morbid obesity is relatively rare in adolescents, few results have bten accumulated so far. OBJECTIVES To prove the safety and efficacy of LSG turgery in an adolescent population METHODS Data were prospectively collected regarding adolescent patients undergoing LSG. All patients underwent pre- and postoperative medical and professional evaluation by a multidisciplinary team. RESULTS Between the years 2006 and 2011, 32 adolescents underwent LSG in our center (20 females and 12males). Mean age was 16.75 years (range 14-18 years), mean weight was 121.88 kg (83-178 kg), and mean body mass index 43.23 (35-54). Thirty-four comorbid conditions were identified. LSG was the primary bariatric procedure in all the patients. Mean operative time was 60 minutes (range 45-80 min). Tiere were two complications (6.25%): an early staple line leak and a late acute cholecystitis. There were no deaths. Mean percent excess weight loss at 1, 3, 6, 9,12, 24, 36, 48, and 60 months post-surgery was 27.9%, 41.1%, 62.6%, 79.2%, 81.7%, 71%, 75%, 102.9% and 101.6%, respectively. Comorbidities were completely resolved or ameliorated within 1 year folllowing surgery in 82.4% and 17.6%, respectively. CONCLUSIONS LSG is feasible and safe in morbidly obese adolescents, achieving efficient weight loss and impressive resolution of comorbidities. Further studies are required to evaluate the long-term results of this procedure as well as its place among other bariatric options.

[1]  B. Antonisamy,et al.  Laparoscopic Sleeve Gastrectomy in 108 Obese Children and Adolescents Aged 5 to 21 Years , 2012, Annals of surgery.

[2]  José Salinas,et al.  Laparoscopic sleeve gastrectomy in obese adolescents: results in 51 patients. , 2012, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[3]  Evelyn P. Whitlock,et al.  Effectiveness of Weight Management Interventions in Children: A Targeted Systematic Review for the USPSTF , 2010, Pediatrics.

[4]  S. Ikramuddin,et al.  The surgical approach to management of pediatric obesity: When to refer and what to expect , 2009, Reviews in Endocrine and Metabolic Disorders.

[5]  C. Lynn,et al.  Bariatric surgery for obese adolescents: should surgery be used to treat the childhood obesity epidemic? , 2009 .

[6]  R. Goldman,et al.  Primary care screening for childhood obesity: a population-based analysis. , 2007, The Israel Medical Association journal : IMAJ.

[7]  J. Morrison,et al.  Metabolic Syndrome in Childhood Predicts Adult Cardiovascular Disease 25 Years Later: The Princeton Lipid Research Clinics Follow-up Study , 2007, Pediatrics.

[8]  P. Schauer,et al.  Initial outcomes of laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents. , 2007, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[9]  S. Mizrahi,et al.  Laparoscopic Gastric Banding in Adolescents , 2006, Obesity surgery.

[10]  K. Widhalm,et al.  Laparoscopic Adjustable Gastric Banding in Adolescents: The Austrian Experience , 2006, Obesity surgery.

[11]  P. Schauer,et al.  Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents. , 2005, Journal of pediatric surgery.

[12]  Manfred S. Green,et al.  Overweight and obesity prevalence in Israel: findings of the first national health and nutrition survey (MABAT). , 2005, The Israel Medical Association journal : IMAJ.

[13]  A. Szold,et al.  Bariatric surgery in adolescence. , 2003, Journal of pediatric surgery.

[14]  P. Schauer,et al.  Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents☆ , 2003 .

[15]  M. Vanhala,et al.  Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study , 1998, BMJ.

[16]  J. Pratt,et al.  ASMBS pediatric committee best practice guidelines. , 2012, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[17]  C. Ståhl,et al.  A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes. , 2010, Journal of pediatric surgery.

[18]  Updated position statement on sleeve gastrectomy as a bariatric procedure. , 2010, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[19]  Kevin W Lutz,et al.  Effectiveness of primary care interventions for weight management in children and adolescents: an updated, targeted systematic review for the USPSTF , 2010 .

[20]  Melodie K. Moorehead,et al.  Updated Bariatric Analysis and Reporting Outcome System (BAROS). , 2009, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[21]  H. Till,et al.  Efficacy of laparoscopic sleeve gastrectomy (LSG) as a stand-alone technique for children with morbid obesity. , 2008, Obesity surgery.

[22]  Jessica M. Langer,et al.  Psychosocial Status in Adolescents Undergoing Bariatric Surgery , 2008, Obesity surgery.

[23]  D. Damiani,et al.  Bariatric Surgery in Pediatrics - Is it Time? , 2007, Journal of pediatric endocrinology & metabolism : JPEM.

[24]  V. Garcia,et al.  Adolescent Bariatric Surgery: Treatment Delayed, Treatment Denied, a Crisis Invited , 2006, Obesity surgery.