Outcomes of adolescents compared with young adults after bariatric surgery: an analysis of 227,671 patients using the MBSAQIP data registry

Poliakin, Lauren; Roberts, Alexandra J.; Thompson, Kyle J.; Raheem, Enayetur; McKillop, Iain H.; Nimeri, Abdelrahman

doi:10.1016/j.soard.2020.05.028

Cited by 17 publications

(14 citation statements)

References 34 publications

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“…Reports of studies from different surgical fields consistently report noninferior or even superior results when operating on younger patients. 19–22…”

Section: Discussionmentioning

confidence: 99%

“…Reports of studies from different surgical fields consistently report noninferior or even superior results when operating on younger patients. [19][20][21][22] The world Professional Association for Transgender Health (WPATH) and the Endocrine Society state in their standard of care guidelines that there is insufficient evidence to recommend a specific age requirement for chest masculinization surgery. Moreover, clinicians must determine the optimal timing of chest surgery for transmasculine individuals based upon the physical and mental health status of the patient.…”

Section: Discussionmentioning

confidence: 99%

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Age-related Outcomes of Chest Masculinization Surgery: A Single-surgeon Retrospective Cohort Study

Skorochod

Rysin

Wolf

2023

Plastic and Reconstructive Surgery - Global Open

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Background: Many transmasculine individuals face chest dysphoria, an emotional distress associated with breast development. The definitive management for reduction of existing breast tissue and alleviation of chest dysphoria comes in the form of chest masculinization surgery. Over the years, a substantial increase in the number of youth seeking gender-affirming chest masculinization surgery was observed globally. The study was hypothesized to answer the question as to whether the age limit of chest masculinization surgery should be lowered to include adolescents. Methods: A retrospective cohort study was conducted, based on the experience of a single surgeon over a period of 20 years. Results: Two-hundred eight patients were included in this cohort. Patients were divided into two equal groups based on their age. No statistically significant differences between the groups were observed in terms of resected breast tissue (P = 0.62 and 0.30, for the right and left breast, accordingly), auxiliary liposuction (P = 0.30), liposuction volume (P = 0.20), procedure (P = 0.15), postoperative drains (P = 0.79), and surgery duration (P = 0.72). Statistically significant differences were found in the 18 years or younger group, with lower rates of complication (P < 0.001), lower rates of revision surgery (P = 0.025), and higher satisfaction rankings (P < 0.001). Apart from age, no other factors were found to potentially explain the different rates of complications between the age groups. Conclusion: Patients aged 18 or younger opting for chest masculinization surgery experience fewer complications and revision procedures while having higher satisfaction rates with the surgical outcome.

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“…Reports of studies from different surgical fields consistently report noninferior or even superior results when operating on younger patients. 19–22…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Age-related Outcomes of Chest Masculinization Surgery: A Single-surgeon Retrospective Cohort Study

Skorochod

Rysin

Wolf

2023

Plastic and Reconstructive Surgery - Global Open

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“…Bariatric surgery in adolescent patients is increasing in frequency, 3,7 but many authors argue that it is underutilized. 6,14 Despite studies that suggest that adolescent bariatric surgery is just as safe 3,4,6,7 as or even safer 5 than adult bariatric surgery, apprehension to further adoption understandably persists.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Complications Following Bariatric Surgery for Adolescent Patients

Cheng

Grinberg

Ashbrook

et al. 2023

The American Surgeon™

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Background Bariatric surgery for adolescent patients has been shown to be safe but potentially underutilized. A better understanding of operative risk in adolescents may temper apprehension to its adoption. This study intends to examine the association between preoperative risk factors and complications following bariatric surgery for adolescent patients. Methods The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program databank (2015-2020) was queried for all adolescent patients (10 to 19 years). Only patients who underwent sleeve gastrectomy or gastric bypass were included. Multivariable regression examined the association between patient characteristics and complications. Results A total of 7785 adolescent patients satisfied inclusion criteria. The median age was 18 years, 1737 (22%) were male, and the median body mass index was 46. Of all patients, 6675 (86%) and 1310 (14%) underwent sleeve gastrectomy and gastric bypass, respectively. Preoperative chronic steroid use was significantly associated with higher rates of leak (odds ratio [OR] 7.327, P = .009), bleeding (OR 10.791, P = .003), and reoperation (OR 7.685, P < .001). While Pacific Islander race was also significantly associated with higher rates of reoperation (OR 11.773, P = .039), Asian race was significantly associated with higher rates of bleeding (OR 14.527, P = .042). A history of gastroesophageal reflux disease was associated with higher rates of postoperative reintervention (OR 2.306, P = .004). Discussion Readily identifiable preoperative patient characteristics are significantly associated with higher rates of postoperative complications following adolescent bariatric surgery. Additional research is required to determine whether tailoring treatment based on these characteristics can improve outcomes.

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“…Retrospective analysis from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBASQIP) database (USA) confirmed that both LSG and RYGB are relatively safe, but the LSG is associated with a significantly lower rate of major complications in the first month after surgery [ 100 ] and with shorter operative times [ 95 , 101 ], especially in accredited centers [ 93 ].…”

Section: Laparoscopic Sleeve Gastrectomy As Preferred Surgical Approachmentioning

confidence: 99%

Bariatric Surgery in Adolescents: To Do or Not to Do?

et al. 2021

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Pediatric obesity is a multifaceted disease that can impact physical and mental health. It is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic factors. In most cases lifestyle and behavioral modification as well as medical treatment led to poor short-term weight reduction and long-term failure. Thus, bariatric surgery should be considered in adolescents with moderate to severe obesity who have previously participated in lifestyle interventions with unsuccessful outcomes. In particular, laparoscopic sleeve gastrectomy is considered the most commonly performed bariatric surgery worldwide. The procedure is safe and feasible. The efficacy of this weight loss surgical procedure has been demonstrated in pediatric age. Nevertheless, there are barriers at the patient, provider, and health system levels, to be removed. First and foremost, more efforts must be made to prevent decline in nutritional status that is frequent after bariatric surgery, and to avoid inadequate weight loss and weight regain, ensuring successful long-term treatment and allowing healthy growth. In this narrative review, we considered the rationale behind surgical treatment options, outcomes, and clinical indications in adolescents with severe obesity, focusing on LSG, nutritional management, and resolution of metabolic comorbidities.

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Outcomes of adolescents compared with young adults after bariatric surgery: an analysis of 227,671 patients using the MBSAQIP data registry

Cited by 17 publications

References 34 publications

Age-related Outcomes of Chest Masculinization Surgery: A Single-surgeon Retrospective Cohort Study

Age-related Outcomes of Chest Masculinization Surgery: A Single-surgeon Retrospective Cohort Study

Predictors of Complications Following Bariatric Surgery for Adolescent Patients

Bariatric Surgery in Adolescents: To Do or Not to Do?

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