Mid-term Results of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Adolescent Patients

Abstract

The prevalence and severity of obesity in children and adolescents has been increasing in recent years at an unprecedented rate. Morbidly obese children will almost certainly develop severe comorbidities as they progress to adulthood, and bariatric surgery may provide the only alternative for achieving a healthy weight. The aim of this study was to assess the long-term outcomes and safety of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) as new treatment modalities for morbidly obese adolescents. We conducted a retrospective review of a prospectively collected database of all adolescent patients who underwent LSG and RYGB under IRB protocol at the Bariatric and Metabolic Institute in Cleveland Clinic Florida between 2002 and 2011. Patients were also contacted by phone, adhering to HIPAA regulations, and were asked to answer a survey. Eighteen adolescents had a bariatric procedure performed at this institution. The mean age was 17.5 years, the average weight was 293.1 lbs, and the average BMI was 47.2 kg/m2. The mean follow-up period consisted of 55.2 months. The postoperative weight at 55 months follow-up was 188.4 lbs and average BMI was 30.1 kg/m2. Fifteen of the patients were available for follow-up. Thirteen out of 16 (81%) comorbidities in patients available for follow-up were in remission following rapid weight loss. The long-term follow-up and perioperative morbidity shown in this study suggest that LSG and LRYGB appear to be safe and effective operations in morbidly obese adolescents.

Psychosocial Status and Mental Health in Adolescents before and after Bariatric Surgery: A Systematic Literature Review

“…The majority of studies were from the USA, only three were from Europe, i.e., Austria [ 34 ], Portugal [ 35 ], and Sweden [ 36 ]. Six studies reported data on 173 adolescent patients before bariatric surgery with the number of patients ranging from 10 to 40 [ 34 , 36 , 37 , 38 , 39 , 40 ]; six studies reported data on 227 adolescent patients after bariatric surgery with the number of patients ranging from 10 to 101 [ 35 , 36 , 41 , 42 , 43 , 44 , 45 ]. The gender in all studies was predominantly female, except for one [ 34 ].…”

“…The study designs varied between retrospective reviews of clinical charts of patients [ 37 , 38 , 39 , 40 , 45 ], clinical follow-ups after examinations have been carried out [ 34 , 41 ], and prospective feasibility, safety or observational studies [ 35 , 36 , 42 , 43 , 44 ]. Surgical procedures were either LAGB [ 34 , 35 , 37 , 41 , 42 ] or RYGB [ 36 , 39 , 43 , 44 , 45 ] or were not specified [ 38 , 40 ]. Most studies dealt with depressive disorders and depressive disorder symptoms in bariatric surgery patients, while one [ 36 ] described depressive and anxiety disorder symptoms from a pre- and post-operative point of view and another reported on pre-operative eating disorder symptoms [ 34 ].…”

“…In two studies, the lowest level of depressive symptoms was reported 1 year after surgery [ 43 , 44 ]. Another study documented improvement of clinical depression in 75% of all affected patients [ 45 ]. Tendencies towards an increased level of depressive disorder symptoms were observed 18 to 24 months after surgery [ 44 ].…”

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

“…Even in earlier studies like the one that Cozacov published in 2014, show the comparable efficiency of RYGB and sleeve gastrectomy in enabling weight loss in adolescents with obesity with similar rates of comorbidity resolution. The author's preference for sleeve gastrectomy seems motivated by the simplicity of the surgical procedure -absence of anastomosis, the restrictive component that comes with serious stomach volume reduction and the hormonal down regulation of hunger hormones induced by stomach partial resection, that results in a long-term reduction of hunger feeling (18).…”

Laparoscopic vertical sleeve gastrectomy significantly improves short term weight loss as compared to laparoscopic adjustable gastric band placement in morbidly obese adolescent patients

“…Weight loss surgery is now considered the most effective treatment for morbidly obese adults [28]. Studies on the efficacy of bariatric surgery in adolescent patients have shown promising results with profound short term and sustained long term weight loss [9,10,13,15,17,20,21,24,25,[29][30][31][32][33][34][35][36][37][38].…”