Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population

Arafat, Mohammod; Norain, Abdullah; Burjonrappa, Sathyaprasad

doi:10.1016/j.jpedsurg.2018.10.089

Cited by 24 publications

(10 citation statements)

References 9 publications

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“…Among these techniques, laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) have gained the most popularity. However, there is a sharp trend towards the utilization of LSG over the last decade and a decline in the use of LRYGB [8,9]. Some studies suggest that LSG is easier and faster to perform and potentially safer compared with LRYGB [8,10], while some indicate that LRYGB is more potent than LSG [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Comparison of LRYGB and LSG in Obese Patients Including the Effects on QoL, Comorbidities, Weight Loss, and Complications: a Systematic Review and Meta-Analysis

Sun

et al. 2019

OBES SURG

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Purpose To systematically and comprehensively evaluate the differences between laparoscopic Roux-en-Y gastric bypass (LRYGB) versus sleeve gastrectomy (LSG) in obese patients. Methods A systematic literature search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to December 2018. The meta-analysis was performed by the RevMan 5.3 software. Results Twenty-three articles with 7443 patients were included. In short term (< 3 years), LRYGB was superior to LSG in terms of improving comorbidities (T2D, odds ratio (OR) 1.93, 1.06-3.52, P < 0.05, hypertension, OR 1.59, 1.08-2.34, P < 0.05, dyslipidemia, OR 1.61, 1.05-2.46, P < 0.05), but there were no differences in the midterm and long term. Quality of life (QoL) after bariatric surgery was included, but no differences were observed in the QoL after LRYGB or LSG (gastrointestinal quality of life index (GIQLI) and Moorehead-Ardelt quality of life questionnaire (M-A-Q), P > 0.05). LRYGB achieved a higher EWL% than LSG (after 3 years, WMD 5.48, 0.13-10.84. P < 0.05; after 5 years, WMD 4.55, 1.04-8.05, P < 0.05) in long term, but no significant differences were found during 0.25-to 2.0-year follow-up. The rate of early and late complications was much higher in LRYGB than in LSG (early complications, OR = 2.11, 95% CI = 1.53-2.91, P < 0.001; late complications, OR = 2.60, 95% CI = 1.93-3.49, P < 0.001). Conclusions This meta-analysis showed that LRYGB was more effective than LSG in comorbidities' resolution or improvement in short term. For weight loss, LRYGB had better long-term effects than LSG. In addition, no differences were observed in the quality of life after LRYGB or LSG. LRYGB was associated with more complications than LSG.

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Section: Introductionmentioning

confidence: 99%

A Comprehensive Comparison of LRYGB and LSG in Obese Patients Including the Effects on QoL, Comorbidities, Weight Loss, and Complications: a Systematic Review and Meta-Analysis

Sun

et al. 2019

OBES SURG

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“…These complication rates are also lower than that reported for adult patients undergoing MBS during the COVID‐19 pandemic (overall complication rate 6.8% for adult patients) 14 . The complication rate in this series is greater than that identified from a recent analysis of data from the National Surgical Quality Improvement Program (NSQIP) (surgical complication rate 2.6%), which included data from adolescent patients undergoing MBS prior to the COVID‐19 pandemic 21 . However, complications may have been classified differently between the two studies, and given the NSQIP study had a larger cohort of patients (n = 2625) albeit over a 10‐year period, it is difficult to directly compare results.…”

Section: Discussionmentioning

confidence: 60%

30‐Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID‐19 pandemic – The GENEVA study

Singhal

Super

Alqahtani³

et al. 2021

Pediatric Obesity

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Summary Background Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID‐19) pandemic. Methods This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in‐hospital and 30‐day COVID‐19 and surgery‐specific morbidity/mortality. Results One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre‐operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre‐operative testing for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self‐isolate pre‐operatively. Two patients developed symptomatic SARS‐CoV‐2 infection post‐operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions MBS in adolescents with obesity is safe during the COVID‐19 pandemic when performed within the context of local precautionary procedures (such as pre‐operative testing). The 30‐day morbidity rates were similar to those reported pre‐pandemic. These data will help facilitate the safe re‐introduction of MBS services for this group of patients.

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“…In contrast there has been a strong focus in the literature on surgical interventions and strategies, including pre-and post-surgical care, 60,61 management of complications, 61 and reducing surgical risk; with 10 studies identified (only two were eligible for inclusion) targeting pre-surgical rapid weight loss. 51,56 Of the studies that included structured intensive lifestyle inpatient programs, two studies 49,50,53 incorporated some patient choice aimed at improving decision-making related to healthy choices to improve sustainability at home.…”

Section: Discussionmentioning

confidence: 99%

Non-Surgical Interventions for Hospitalized Adults with Class II or Class III Obesity: A Scoping Review

Rees¹,

Collins²,

Vlieger³

et al. 2021

DMSO

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Adult inpatients with Class II or III obesity and comorbidities have a high health burden with frequent hospitalizations. Surgical risk and patient choice can be contraindications to bariatric surgery, which is considered the gold standard treatment. The best approach to non-surgical management for this adult inpatient group is currently unknown. The aim of this scoping review was to summarize current research in the inpatient setting. The unpublished literature and six electronic database searches identified 4,582 articles, with 12 articles (reporting on 10 studies) eligible and included. The literature on the interventions and their key components in the non-surgical care of the adult inpatient with Class II or III obesity were mapped identifying service provision successes and gaps. The articles reported on intensive lifestyle interventions, comparison of oxygen administration regimes, total parenteral nutrition regimens, and pre-surgical rapid weight loss. Study designs included evaluation (n=1), before–after intervention studies (n=3), and randomized/non-randomized controlled trials (n=6). The classification of obesity as a chronic disease is not universal resulting in reduced inpatient treatment options. Recommendations for consumers, practitioner practice, health policy-makers and future research priorities are reported. Further research in the development of cost-effective inpatient models of care is indicated.

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Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population

Cited by 24 publications

References 9 publications

A Comprehensive Comparison of LRYGB and LSG in Obese Patients Including the Effects on QoL, Comorbidities, Weight Loss, and Complications: a Systematic Review and Meta-Analysis

A Comprehensive Comparison of LRYGB and LSG in Obese Patients Including the Effects on QoL, Comorbidities, Weight Loss, and Complications: a Systematic Review and Meta-Analysis

30‐Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID‐19 pandemic – The GENEVA study

Non-Surgical Interventions for Hospitalized Adults with Class II or Class III Obesity: A Scoping Review

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