Trends in Adolescent Bariatric Procedures: a 15-Year Analysis of the National Inpatient Survey

Salimi-Jazi, Fereshteh; Chkhikvadze, Tamta; Shi, Junxin; Pourmehdi-lahiji, Arian; Moshksar, Amin; Rafeeqi, Talha; Pratt, Janey; Bruzoni, Matías; Chao, Stephanie

doi:10.1007/s11695-022-06265-9

Cited by 8 publications

(5 citation statements)

References 41 publications

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“…Pediatric obesity is a chronic disease that continues into adulthood and carries significant risk of morbidity and early mortality [8]. Until recently, there have been few pharmacotherapy options for patients under the age of 18 available and fewer that resulted in significant and sustained weight loss, and thus MBS has been performed in children in increasing numbers [9]. There are now many reports documenting the medical benefits of MBS in children.…”

Section: Discussionmentioning

confidence: 99%

Outcomes after metabolic and bariatric surgery in preteens versus teens using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and center‐specific data

Shah,

Liang,

Bruzoni

et al. 2023

Obesity

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ObjectiveThe American Academy of Pediatrics (AAP) recently released clinical guidelines for the treatment of childhood obesity, including surgery being appropriate for children 13 years of age and older. The use of this age cut‐off was due to a lack of data for children younger than 13. To address this knowledge gap, the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried to compare outcomes in preteens to teens after bariatric surgery hypothesizing that there would be no difference in outcomes between the two groups.MethodsPatients from the MSAQIP database (2016–2021) were identified and divided into groups <13 years and 13–18 years and were matched using propensity scores based on race, sex, and preoperative BMI. Outcomes were compared including change in BMI, complication rates, 30‐day readmission or reoperation, and mortality. Additionally, the centers responsible for the bulk of the preteen patient entries queried their center‐specific databases to evaluate weight loss over time.ResultsA total of 4755 patients were identified, 47 of whom were <13 years of age. Preteens had similar sex distribution (66% vs. 75% female), were more likely to be Black (27.7% vs. 18.3%) or Hispanic (21.3% vs. 7.6%) race, and weighed less (274 ± 58 vs. 293 ± 85 lb, p = 0.01), but they had similar BMI (46.9 ± 7 vs. 47 ± 13 kg/m2) as their teen counterparts. Preteens were more likely to suffer from sleep apnea (34% vs. 19%, p < 0.01) and insulin‐dependent type 2 diabetes (10.6% vs. 1.8%, p < 0.01). There were no complications in the preteens compared to teens (0% vs. 0.5%), and they did not undergo any unplanned readmissions (0% vs. 2.9%) or reoperations (0% vs. 0.8%) within 30 days of surgery. There were also no mortalities reported in preteens (0% vs. 0.1%). The risk‐adjusted decrease in BMI between preteens and teens was also comparable at 30 days (4.2 [95% CI: 3.0–5.4] vs. 4.6 [95% CI: 4.4–4.7], p = 0.6). Decrease in BMI in preteens was 7 ± 3 kg/m2 at 3 months and 9 ± 4 kg/m2 at 12 months after surgery, which represented a percentage BMI change of 16 ± 7 and 20 ± 8, respectively.ConclusionsThis study demonstrates that bariatric surgery in preteens is safe and efficacious when performed at specialized centers, and that age criteria may not be required. The AAP and others are encouraged to include age cut‐offs in their guidelines for children with obesity and bariatric surgery only when data are available to support their inclusion.

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Section: Discussionmentioning

confidence: 99%

Outcomes after metabolic and bariatric surgery in preteens versus teens using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and center‐specific data

Shah,

Liang,

Bruzoni

et al. 2023

Obesity

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“…Outcomes of MBS in both adult and adolescent studies show similar results including improvement and resolution of obesity driven diseases [ 131 ]. A recent report analyzed trends in adolescent metabolic and bariatric procedures over 15 years finding a significant increase in use of MBS in adolescents although concluding that MBS remains underutilized [ 132 ]. MBS guidelines in the pediatric population provide clinical direction for this treatment modality [ 128 , 133 ].…”

Section: Advanced Therapies For Children With Obesity and Severe Obesitymentioning

confidence: 99%

Medication-induced weight gain and advanced therapies for the child with overweight and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022

Cuda¹,

Censani

Kharofa

et al. 2022

Obesity Pillars

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“…LSG is a restrictive procedure, while OAGB has a predominant malabsorptive component with modulation of intestinal hormones (12)(13)(14)(15)(16). Both procedures have been found to be faster and easier to execute and have similar or better weight loss compared to LRYGB, with comparable or superior postoperative safety profiles (12)(13)(14)(15)(16).…”

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confidence: 99%

“…One anastomosis gastric bypass (OAGB) is an even newer surgical approach that has gained popularity in the adult population and is now being carried out as a routine procedure in most countries worldwide (14)(15)(16)(17). LSG is a restrictive procedure, while OAGB has a predominant malabsorptive component with modulation of intestinal hormones (12)(13)(14)(15)(16). Both procedures have been found to be faster and easier to execute and have similar or better weight loss compared to LRYGB, with comparable or superior postoperative safety profiles (12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

“…Laparoscopic RY gastric bypass (LRYGB), which was the gold standard procedure at the beginning of the 21st century (11), has been challenged by the laparoscopic sleeve gastrectomy (LSG) approach during the last decade (12). Recent systemic review and meta-analysis has reported a gradual increase in the utilization of bariatric surgery among adolescents and a significant shift away from laparoscopic gastric bypass to sleeve gastrectomy in last 15 years (13). One anastomosis gastric bypass (OAGB) is an even newer surgical approach that has gained popularity in the adult population and is now being carried out as a routine procedure in most countries worldwide (14)(15)(16)(17).…”

mentioning

confidence: 99%

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Laparoscopic Sleeve Gastrectomy Versus One Anastomosis Gastric Bypass in Adolescents With Obesity

Sorek¹,

Eldar²,

Cohen³

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objective: Large studies comparing outcomes between laparoscopic sleeve gastrectomy (LSG) and one anastomosis gastric bypass (OAGB) are scarce and involve adult populations. The aim of the study was to compare perioperative, early postoperative, and 1-year postoperative outcomes of adolescents with obesity who underwent LSG or OAGB surgery. Methods: The medical records of adolescents with obesity who underwent LSG or OAGB at the Tel Aviv Sourasky Medical Center from January 2017 to January 2021 were retrospectively reviewed. Data on their gastrointestinal (GI) symptoms and postoperative quality of life were obtained by a telephone interview. Results: Included were 75 adolescents (median [interquartile range, IQR] age 17.3 [16-18] years) of whom 22 underwent OAGB and 53 underwent LSG. There were no significant preoperative group differences in age, sex, and body mass index score. A low rate of perioperative (5.7% vs 0) and postoperative complication (15.1% vs 10%) with no statistical differences between LSG and OAGB group, respectively, was noted. At 12 months, the percent excessive weight loss + IQR was 42.40% [30.00, 45.00] and 38.00% [33.550, 44.20] in the LSG and OAGB group, respectively (P = NS). The results of the Pediatric Quality of Life Inventory Gastrointestinal Symptoms scale revealed significantly less food limitation and heartburn after OAGB compared to LSG (food limitation 71.63 vs 53.85 and heartburn 83.654 vs 61.6, P = 0.03 and P = 0.029, respectively). Conclusions: Both surgeries are effective and safe for weight loss in the adolescent population. OAGB was associated with significantly fewer GI symptoms compared to LSG.

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Trends in Adolescent Bariatric Procedures: a 15-Year Analysis of the National Inpatient Survey

Cited by 8 publications

References 41 publications

Outcomes after metabolic and bariatric surgery in preteens versus teens using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and center‐specific data

Outcomes after metabolic and bariatric surgery in preteens versus teens using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and center‐specific data

Medication-induced weight gain and advanced therapies for the child with overweight and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022

Laparoscopic Sleeve Gastrectomy Versus One Anastomosis Gastric Bypass in Adolescents With Obesity

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