An update on 73 US obese pediatric patients treated with laparoscopic adjustable gastric banding: comorbidity resolution and compliance data

Nadler, Evan P.; Youn, Heekoung; Ren, Christine; Fielding, George

doi:10.1016/j.jpedsurg.2007.09.035

Cited by 119 publications

(68 citation statements)

References 24 publications

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“…Short-term has also been broken down into six months, one year, 18 months, two years, and then three years in various studies. [16][17][18][19][20] These results set the realistic expectations for patients, but they also can show slow, sustained weight loss with laparoscopic AGB with time, as opposed to quicker weight loss in the first year with the LRYGB.…”

Section: Short-term Weight Lossmentioning

confidence: 64%

Past, present, and future: Critical analysis of use of gastric bands in obese patients

Snyder¹,

Worley²,

Aluka³

et al. 2010

DMSO

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Adjustable gastric banding (AGB) is quickly becoming the most popular bariatric operation performed in the United States and Canada. Patients are particularly fond of the simplicity of the tool, the relatively low morbidity of the surgery, the quick recovery, and overall results. The gastric band has evolved over its 35-year history into a very successful adjustable tool used to restrict food consumption and limit caloric intake. The percent of excessive weight loss after banding can range from 30%-60% and depends on the time out from surgery. Along with weight loss, there is good resolution of the co-morbid conditions that are associated with excess weight and improvements in quality of life demonstrated after banding. Nutrition and follow up are extremely important after banding to ensure good compliance and adequate weight loss. Failure to follow the postoperative diet, exercise regiment, or mechanical failure of the band can lead to failure to lose adequate weight. While there are particular early and late complications associated with this surgery, the safety profile of the AGB is very appealing when compared to other bariatric operations. As we continue to reduce the morbidity of the procedure, the simple adjustable band concept has a lot of potential to remain a primary technique of maintaining long term weight loss. In conclusion, AGB has and continues to play an important role in the treatment of morbid obesity. It offers reasonably good weight loss results with very little morbidity, and the future of the adjustable band is bright.

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Section: Short-term Weight Lossmentioning

confidence: 64%

Past, present, and future: Critical analysis of use of gastric bands in obese patients

Snyder¹,

Worley²,

Aluka³

et al. 2010

DMSO

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“…Since the 1991 National Institutes of Health consensus statement, more data have become available on the safety and effectiveness of bariatric surgery in adolescents for long-term sustained weight loss and comorbidity resolution, particularly when approached on an interdisciplinary level at experienced centers. [197][198][199][200][201] The consensus statement was revisited and updated in 2005 by the American Society for Bariatric Surgery, 25 expanding the indications to adolescents and possibly to individuals with lower BMI (30 to 34.9 kg/m 2 ) with associated comorbid conditions. Bariatric surgery for patients with BMI of 30 to 34.9 kg/m 2 and comorbidities is aggressively considered because of the poor results of nonoperative weight loss regimens.…”

Section: General Considerationsmentioning

confidence: 99%

Bariatric Surgery and Cardiovascular Risk Factors

Poirier¹,

Cornier²,

Mazzone³

et al. 2011

Circulation

288

130

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T he rate of obesity is rising logarithmically, especially in those with severe obesity (body mass index [BMI] Ͼ40 kg/m 2 ). Cardiologists, endocrinologists, internists, family practitioners, and most healthcare professionals are increasingly confronted with the severely obese patient and with postoperative bariatric patients because obesity is associated with significant morbidity and increased mortality. In addition, more adolescents these days are severely obese. Substantial long-term successes of lifestyle modifications and drug therapy have been disappointing in this population. The National Institutes of Health has suggested that surgical therapy be proposed to those patients with BMI Ͼ40 kg/m 2 or Ͼ35 kg/m 2 with serious obesity-related comorbidities such as systemic hypertension, type 2 diabetes mellitus, and obstructive sleep apnea. When indicated, surgical intervention leads to significant improvements in decreasing excess weight and comorbidities that can be maintained over time. These include diabetes mellitus, dyslipidemia, liver disease, systemic hypertension, obstructive sleep apnea, and cardiovascular dysfunction. Recent prospective, nonrandomized, observational, or case-control population studies have also shown bariatric surgery to prolong survival in the severely obese. Different types of bariatric procedures are being performed. Historically, operative mortality was between 0.1% and 2.0% with more recent data not exceeding 1%. Early complications include pulmonary embolus (0.5%), anastomotic leaks (1.0% to 2.5%), and bleeding (1.0%). Late complications include anastomotic stricture, anastomotic ulcers, hernias, band slippage, and behavioral maladaptation. The number of bariatric operations being performed is increasing tremendously as a result of increasing medical need and the evolution of safer surgical techniques and guidelines. Currently, bariatric surgery should be reserved for patients who have severe obesity in whom efforts at medical therapy have failed and an acceptable operative risk is present.

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“…6,7,26,42,157,158 Resolution of obesity-related comorbidities has been shown in majority of adolescents undergoing surgery. 157 Those with a MS had more improvement with surgical weight loss.…”

Section: Weight-loss Surgerymentioning

confidence: 99%

Nonalcoholic fatty liver disease: a challenge for pediatricians

Widhalm

Ghods

2010

Int J Obes

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Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment. Aim: To provide a detailed review for diagnosis and management of NAFLD and NASH. Methods: By using Pubmed to find review articles and relevant research. Results: The prevalence ranges from at least 3% in children overall to about 50% in obese children. The noninvasive biomarkers can be used to identify NAFLD/NASH patients. Diagnostic criteria based on biochemical and immunological indicators in the high-risk group of children could prevent about half of cases from receiving an invasive test. The pharmacological and surgical interventions have shown a growing role in pediatric NAFLD. Novel treatment modalities, such as probiotics, have hardly been studied. Conclusion: Early diagnosis by using noninvasive screening methods in high-risk groups is the most effective strategy against the NAFLD. The biology of early growth and development, including hepatic metabolism, may hold the key to pediatric NAFLD. Prevention of overweight children and childhood obesity is undoubtedly the best strategy for treating NAFLD.

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An update on 73 US obese pediatric patients treated with laparoscopic adjustable gastric banding: comorbidity resolution and compliance data

Cited by 119 publications

References 24 publications

Past, present, and future: Critical analysis of use of gastric bands in obese patients

Past, present, and future: Critical analysis of use of gastric bands in obese patients

Bariatric Surgery and Cardiovascular Risk Factors

Nonalcoholic fatty liver disease: a challenge for pediatricians

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