One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group

Lawson, M. Louise; Kirk, Shelley; Mitchell, Terry; Chen, Mike K.; Loux, Tara; Daniels, Stephen R.; Harmon, Carroll M.; Clements, Ronald H.; Garcia, Victor F.; Inge, Thomas H.

doi:10.1016/j.jpedsurg.2005.10.017

Cited by 207 publications

(150 citation statements)

References 33 publications

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“…Among three pediatric centers using similar operative criteria, 41 adolescents undergoing laparoscopic gastric bypass were followed for at least 1 year. 7 BMI at baseline was 57 kg/m 2 , decreasing by 37% to 36 kg/m 2 by 1 year after surgery. There were no perioperative deaths.…”

Section: The Modern Era Of Bariatric Surgical Procedures For Adolescentsmentioning

confidence: 91%

“…85 We have also demonstrated that bariatric surgery in adolescence results in correction of nascent features of the metabolic syndrome. 7 Particularly significant were a 70% decline in fasting insulin levels, a 13% decline in fasting glucose concentrations and a 30% decrease in triglyceride levels following adolescent surgical weight loss.…”

Section: Cardiovascular Risksmentioning

confidence: 98%

“…The precise frequency of weight regain after adolescent gastric bypass is not clear but may be as high as 10-20%. 7,27,28 Adjustable gastric banding ( Figure 1) is the most recent procedure introduced for surgical weight management, and is gaining worldwide acceptance. 33 During this procedure, a device consisting of a synthetic band with a small inflatable inner balloon is placed around the proximal stomach, just beyond the gastroesophageal junction.…”

Section: The Modern Era Of Bariatric Surgical Procedures For Adolescentsmentioning

confidence: 99%

“…[106][107][108][109][110][111] Adolescents undergoing bariatric surgery also demonstrate significant fasting hyperinsulinemia and insulin resistance as estimated by homeostasis model assessment (HOMA-IR) was abnormal in 64% of patients preoperatively. 7 However, in contrast to adult outcomes, surgical weight loss in adolescents resulted in complete resolution of fasting hyperinsulinemia. 7 HOMA-IR decreased by 78% overall (Po0.01) and completely normalized in all but one patient (Po0.01).…”

Section: Endocrine Changesmentioning

confidence: 99%

“…6 Indeed, for adolescents with BMI values more than 40 kg/m 2 , some have reported only 3% BMI reduction after 1 year for those adolescents participating in well-designed, age-appropriate weight management program. 7 Poor weight loss results have also been reported for pre-adolescents with extreme obesity. 8 Bariatric surgery is an effective treatment option that significantly reduces adiposity and improves obesity-related comorbidities in adults.…”

Section: Introductionmentioning

confidence: 99%

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Bariatric surgery for pediatric extreme obesity: now or later?

2006

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Obesity is a multifactorial disease of epidemic and global proportions that poses the most significant threat to the health of our younger generations. Those who are the most extremely affected bear the largest burden of health problems. In the US, extreme obesity affects approximately 9 million adults and 2 million children, and is associated with both immediate health problems and later health risk, including premature mortality. Present medical and behavioral interventions for extreme obesity in adults and children rarely result in the significant, durable weight loss necessary to improve health outcomes, prompting a search for more aggressive measures. Weight loss (bariatric) surgery has been advocated as an intervention for those with extreme obesity. In adults, bariatric surgery results in prolonged weight control and improvement in serious obesity comorbidities, namely type 2 diabetes, dyslipidemias, hypertension and obstructive sleep apnea syndrome. A surge in weight loss operations for adolescents has been observed recently, with a threefold increase in case volumes nationwide from 2000 to 2003. Current evidence suggests that after bariatric surgery, adolescents lose significant weight and serious obesity-related medical conditions and psychosocial status are improved. Thus it is reasonable to propose that bariatric surgery performed in the adolescent period may be more effective treatment for childhood-onset extreme obesity than delaying surgery for extremely obese youth until adulthood. This position has been echoed by a number of groups and an independent systematic review. Finally, it is conceivable that bariatric surgery performed in adulthood for childhood onset extreme obesity may not be as effective for comorbidity treatment as surgery performed earlier during adolescence. The purpose of this review is to examine the evidence, which supports early rather than later use of bariatric surgery in the treatment of extreme obesity, and to present this information in light of the medical and surgical risks of bariatric surgery.

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Section: The Modern Era Of Bariatric Surgical Procedures For Adolescentsmentioning

confidence: 91%

Section: Cardiovascular Risksmentioning

confidence: 98%