High Complication Rate after Swedish Adjustable Gastric Banding in Younger Patients ≤25 Years

Mittermair, Reinhard; Aigner, Franz; Obermüller, Sabine

doi:10.1007/s11695-008-9758-6

Cited by 18 publications

(25 citation statements)

References 15 publications

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“…In Europe, where there is greater experience with the band, several groups have reported higher reoperative rates for dysphagia, band migration, port displacement, and infection in younger patients. 44,45 More recently, an Australian group reported a 33% reoperation rate for patients aged 14 to 18 years who underwent LAGB in a prospective randomized controlled trial. 13 Many centers have abandoned gastric banding because of poor long-term results, the need for frequent adjustments, the complications associated with implantation of a foreign body, and concerns with chronic esophageal obstruction.…”

Section: Figurementioning

confidence: 99%

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Jen

Rickard²,

Shew³

et al. 2010

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:There has been a dramatic increase in the use of adolescent bariatric surgery. However, previous studies were unable to distinguish laparoscopic versus open procedures. Furthermore, the use of laparoscopic adjustable gastric banding (LAGB) has not been studied on a population level. WHAT THIS STUDY ADDS:The rate of LAGB increased sevenfold from 2005 to 2007 with a corresponding decrease in the rate of laparoscopic Roux-en-Y gastric bypass. Furthermore, white adolescents represented only 28% of those who were overweight but accounted for 65% of the procedures.abstract OBJECTIVE: The goal of this study was to evaluate trends, and outcomes of adolescents who undergo bariatric surgery. PATIENTS AND METHODS: RESULTS:Overall, 590 adolescents (aged 13-20 years) underwent bariatric surgery in 86 hospitals. White adolescents represented 28% of those who were overweight but accounted for 65% of the procedures. Rates of laparoscopic adjustable gastric banding (LAGB) increased 6.9-fold from 0.3 to 1.5 per 100 000 population (P Ͻ .01), whereas laparoscopic Roux-en-Y gastric bypass (LRYGB) rates decreased from 3.8 to 2.7 per 100 000 population (P Ͻ .01). Self-payers were more likely to undergo LAGB (relative risk [RR]: 3.51 [95% confidence interval: 2.11-5.32]) and less likely to undergo LRYGB (RR: 0.45 [95% confidence interval: 0.33-0.58]) compared with privately insured adolescents. The rate of major in-hospital complication was 1%, and no deaths were reported. Of the patients who received LAGB, 4.7% had band revision/removal. In contrast, 2.9% of those who received LRYGB required reoperations. CONCLUSIONS:White adolescent girls disproportionately underwent bariatric surgery. Although LAGB has not been approved by the US Food and Drug Administration for use in children, its use has increased dramatically. There was a complication rate and no deaths. Long-term studies are needed to fully assess the efficacy, safety, and health care costs of these procedures in adolescents.

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Section: Figurementioning

confidence: 99%

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Jen

Rickard²,

Shew³

et al. 2010

Pediatrics

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“…• Liquids should be zero calories and noncarbonated: [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] ounces should be consumed daily to maintain adequate hydration status.…”

Section: Nutritionmentioning

confidence: 99%

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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“…[22][23][24][25] It involves placing an adjustable band around the stomach that restricts the passage of food. The band tightness is adjusted by needle injection of fluid into a port that is located in the subcutaneous tissue.…”

Section: General Requirementsmentioning

confidence: 99%

“…7,8 The durability of gastric banding in younger patients has also been questioned because it involves insertion of a foreign body, which is likely to malfunction and ultimately require replacement or removal. 23,24 In the US, sleeve gastrectomy has become increasingly popular in the last few years. This promising procedure is a restrictive procedure that involves resection of approximately 70% of the stomach ( Figure 2C).…”

Section: General Requirementsmentioning

confidence: 99%

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Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

Um¹,

Slusser²,

DeUgarte

2011

OAS

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Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA) is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.

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High Complication Rate after Swedish Adjustable Gastric Banding in Younger Patients ≤25 Years

Cited by 18 publications

References 15 publications

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

Trends and Outcomes of Adolescent Bariatric Surgery in California, 2005–2007

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

Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

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