Obese teenagers treated by Lap-Band System: The Italian experience

Angrisani, Luigi; Favretti, Franco; Furbetta, Francesco; Paganelli, Michele; Basso, Nicola; Doldi, S B; Iuppa, A; Lucchese, Marcello; Lattuada, Ezio; Lesti, G.; Capizzi, Francesco Domenico; Giardiello, Cristiano; Lorenzo, Nicola Di; Veneziani, A; Alkilani, M.; Puglisi, Francesco; Gardinazzi, A.; Cascardo, Antonio; Borrelli, Vincenzo; Lorenzo, Michele

doi:10.1016/j.surg.2005.07.012

Cited by 73 publications

(47 citation statements)

References 22 publications

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“…Reoperation rates, including band removal, have been reported in the 8% to 10% range 239,240 ; however, in the study by O'Brien et al, 216 the overall adverse event rate was 48%, with 24% of subjects requiring reoperation because of proximal gastric pouch enlargement. When one considers treatment options for pediatric patients with many decades of life expectancy, it is also very important to consider that the adult AGB literature demonstrates that risks of late complications, the need for revisional surgery, and device explantation increase over time.…”

Section: Adjustable Gastric Bandingmentioning

confidence: 97%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

882

804

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espite recent data suggesting that the rate of increase of obesity among children and adolescents has slowed and overall prevalence has possibly begun to plateau, 1,2 a worrisome trend has emerged in the form of severe pediatric obesity. As the fastest-growing subcategory of obesity in children and adolescents, 1,3,4 severe obesity afflicts between 4% and 6% of all youth in the United States 3-7 and has both immediate and long-term health consequences. Recent data further Abstract-Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks. (Circulation. 2013;128:1689-1712.)

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Section: Adjustable Gastric Bandingmentioning

confidence: 97%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

882

804

View full text Add to dashboard Cite

show abstract

“…On the other hand, obese adolescents are premature in their physical development and should not be considered for surgical treatment before they reached approximately 95% of their calculated body height. The available data have shown the effectiveness and attractiveness of this surgical method according to its reduction of body mass index (BMI), excessive weight loss (EWL), increase in quality of life, and ability to treat or resolve comorbidities [10,[27][28][29][30]. In 2007 the interdisciplinary European guidelines for bariatric surgery were established, defining the criteria for adolescent patients as well [31].…”

mentioning

confidence: 99%

Long-term results after laparoscopic adjustable gastric banding in adolescent patients: follow-up of the Austrian experience

Silberhumer

Miller²,

Pump³

et al. 2011

Surg Endosc

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“…[8][9][10][11][12] Laparoscopic adjustable gastric banding (LAGB) has not been approved by the US Food and Drug Administration for patients younger than 18 years. Although early results with LAGB have indicated that it is safe and effective, [13][14][15][16] long-term outcomes have not yet been reported for adolescents.…”

mentioning

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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Obese teenagers treated by Lap-Band System: The Italian experience

Cited by 73 publications

References 22 publications

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Long-term results after laparoscopic adjustable gastric banding in adolescent patients: follow-up of the Austrian experience

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

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