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Int J Obes (Lond). 2014 Mar;38(3):334-40. doi: 10.1038/ijo.2013.182. Epub 2013 Sep 19.

Bariatric surgery in adolescents and young adults--safety and effectiveness in a cohort of 345 patients.

Author information

1
Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University Medical Center, Ulm, Germany.
2
1] University Hospital for General-, Visceral-, and Vascular Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany [2] Institute for Quality Assurance in Surgical Medicine at the University Hospital, Magdeburg, Germany.
3
University Hospital for General-, Visceral-, and Vascular Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany.
4
StatConsult Magdeburg, Research Institute for Clinical Research and Development, Magdeburg, Germany.
5
Krankenhaus Sachsenhausen, Frankfurt.
6
1] Institute for Quality Assurance in Surgical Medicine at the University Hospital, Magdeburg, Germany [2] SRH Hospital for General, Visceral, and Pediatric Surgery, Wald-Klinikum Gera, Germany.
7
Hospital for Children and Adolescents, Center of Pediatric Research, Leipzig, Germany.

Abstract

OBJECTIVE:

To examine the safety and effectiveness of adolescent bariatric surgery and to improve treatment recommendations for this age group.

DESIGN:

Prospective longitudinal registry. Since January 2005, patients undergoing bariatric surgery in Germany are enlisted in an online registry called 'study for quality assurance in obesity surgeries'.

SUBJECTS:

Adolescents and young adults up to the age of 21 years, operated from January 2005 to December 2010.

MEASUREMENTS:

Weight, BMI, comorbidities, complication rates.

RESULTS:

N=345 primary procedures were recorded by 58 hospitals. N=51 patients were under the age of 18 years. Follow-up information was available for 48% (n=167) of patients, with an average observation period of 544±412 days (median: 388 days). The most common surgical techniques were gastric banding (n=118, 34.2%), gastric bypass (n=116, 33.6%) and sleeve gastrectomy (n=78, 22.6%). Short-term complications (intra-operative; general postoperative; specific postoperative) were slightly lower for gastric banding (0.8%; 2.5%; 0.8%) than for gastric bypass (2.6%; 5.2%; 1.7%) or sleeve gastrectomy (0%; 9.0%; 7.7%). In accordance with published findings, weight and BMI reduction were lower for gastric banding (-28 kg; -9.5 kg m(-2)) compared to gastric bypass (-50 kg; -16.4 kg m(-2)) P< 0.001 or sleeve gastrectomy (-46 kg; -15.4 kg m(-2)) P< 0.001. Outcomes did not differ between the <18 and ≥18-year-old patients.

CONCLUSION:

Like in adults, bariatric surgery has low short-term complication rates and results in sustained weight loss in adolescents. However, the missing long-term observations prohibit a final conclusion about lasting effectiveness and safety. Clinical trials with structured follow-up programs and mechanisms to ascertain patient adherences are needed.

PMID:
24048144
DOI:
10.1038/ijo.2013.182
[Indexed for MEDLINE]

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