Perioperative Outcomes of Adolescents Undergoing Bariatric Surgery

Abstract

Importance Severe obesity in childhood is a major health problem with few effective treatments. Weight loss surgery (WLS) is being used to treat severely obese adolescents, although with very limited data regarding surgical safety for currently used, minimally-invasive procedures. Objective To assess preoperative clinical characteristics perioperative safety outcomes of severely obese adolescents undergoing WLS. Design This prospective, multi-site observational study enrolled from 2007 through 2012. Setting This study was conducted at 5 academic referral centers in the U.S Participants Consecutive subjects ≤ age 19 years who were approved to undergo (n=277) were offered enrollment into the study; 13 declined participation and 22 did not undergo surgery after enrollment thus the final analysis cohort consisted of 242 individuals. There were no withdrawals. Main Outcomes & Measures This analysis examined preoperative anthropometrics, comorbid conditions, and major and minor complications occurring within 30 days of operation. All data were collected in a standardized fashion. Re-operations and hospital re-admissions were adjudicated by independent reviewers to assess relatedness to the WLS procedure. Results Mean age of participants was 17.1±1.6 years and the median BMI was 50.5 kg/m2. Fifty-one percent demonstrated four or more major co-morbid conditions. Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6% of subjects, respectively. There were no deaths during the initial hospitalization or within 30 days of operation; major complications (eg., reoperation) were seen in 19 subjects (8%). Minor complications (eg., readmission for dehydration) were noted in 36 subjects (15%). All re-operations and 85% of re-admissions were related to WLS. Conclusions & Relevance In this series, adolescents with severe obesity presented with abundant comorbid conditions. We observed a favorable short-term complication profile, supporting the early postoperative safety of WLS in select adolescents. Further longitudinal study of this cohort will permit accurate assessment of long-term outcomes for adolescents undergoing bariatric surgery.

Severe Obesity and Comorbid Condition Impact on the Weight-Related Quality of Life of the Adolescent Patient

“…A synopsis of the study protocol, including study design features, inclusion/exclusion criteria, consent/assent, study visits and procedures, physical measurements, laboratory data collection, and other clinical and self-report data collection was previously published 1 . In addition, methodologic details pertinent specifically to the analyses presented in this article are provided below.…”

Ética e aspectos psicossociais em crianças e adolescentes candidatos a cirurgia bariátrica

“…Inge et al 48 performed the largest study of BS-related complications. They evaluated 242 adolescents in five centers in the USA and adverse effects were classified as major (risk of death) and minor.…”

Bariatric surgery in the treatment of morbid obesity in adolescents (literature review)

“…Данные о безопасности бариатрической хирур-гии у подростков отражены в единичных проспек-тивных исследованиях [26,27]. Противоречивость их результатов связана с нестандартизованностью методов исследования, особенностями состава и разными объемами выборки.…”

“…[26] (277 пациентов; средний возраст 17 лет), 19 (6,8%) подросткам в те-чение 30 дней после плановой бариатрической опе-рации потребовалось повторное вмешательство. Повторная госпитализация в связи с развитием обез-воживания потребовалась 36 пациентам.…”