Background Surgery for obesity and metabolic diseases has been evolved in the light of new scientific evidence, long-term outcomes and accumulated experience. EAES has sponsored an update of previous guidelines on bariatric surgery. Methods A multidisciplinary group of bariatric surgeons, obesity physicians, nutritional experts, psychologists, anesthetists and a patient representative comprised the guideline development panel. Development and reporting conformed to GRADE guidelines and AGREE II standards. Results Systematic review of databases, record selection, data extraction and synthesis, evidence appraisal and evidence-todecision frameworks were developed for 42 key questions in the domains Indication; Preoperative work-up; Perioperative management; Non-bypass, bypass and one-anastomosis procedures; Revisional surgery; Postoperative care; and Investigational procedures. A total of 36 recommendations and position statements were formed through a modified Delphi procedure. and Other Interventional Techniques Disclaimer This clinical practice guideline has been developed under the auspice of the European Association for Endoscopic Surgery (EAES). It is intended to be used primarily by health professionals (e.g. surgeons, anesthetists, physicians) and to assist in making informed clinical decisions on diagnostic measures and therapeutic management. It is also intended to inform individual practice of allied health professionals (e.g. surgical nurses, dietitians, physical rehabilitation therapists, psychologists); to inform strategic planning and resource management by healthcare authorities (e.g. regional and national authorities, healthcare institutions, hospital administration authorities); and to inform patients wishing to obtain an overview of the condition of interest and its management. The use of recommendations contained herein must be informed by supporting evidence accompanying each recommendation and by research evidence that might not have been published by the time of writing the present document. Users must thus base their actions informed by newly published evidence at any given point Electronic supplementary material The online version of this article (

RezumatBackground: Obezitatea la copil este o problemă cu care ne confruntăm din ce în ce mai des. Deşi chirurgia metabolică aplicată copiilor a fost iniţial privită cu scepticism, numărul articolelor ştiinţifice care abordează această problemă şi susţin intervenţia cât mai rapidă este deja coniderabil. Cu toate acestea există, încă multe controverse legate de indicaţia de intervenţie chirurgicală şi rezultatele pe termen lung la aceşti pacienţi. Scop: Analizarea rezultatelor chirurgiei bariatrice la un grup de adolescenţi cu obezitate operaţi în spitalul nostru. Metoda: Am analizat retrospectiv datele tuturor pacienţilor adolescenţi cu obezitate care au fost operaţi -gastrectomie longitudinală laparoscopică sau gastric by pass în perioada 2013noiembrie 2019 într-un Centru de Excelenţă în Chirurgia Bariatrică, urmărind prezenţa preoperator a comorbidităţilor legate de obezitate, evoluţia BMI şi a comorbidităţilor la 12 şi 36 luni postoparator. Rezultate: Şaizeci şi patru de pacienţi au fost incluşi în studiu, 62 cu gastrectomie longitudinală (SG) şi doi cu bypass gastric (GBP). Vârsta medie la momentul operator a fost de 15 ani şi 5 luni (SD 18 luni). Indexul BMI mediu înainte de operaţie a fost 39.45 kg/m 2 (SD 6.9) şi a scăzut la 24.92 kg/m 2 şi 22.7kg/m 2 la 12 respectiv 36 de luni de la intervenţie. Nu s-au înregistrat complicaţii majore perioperatorii, consemnând doar un caz de disfagie prelungită, tranzitorie postoperator. Durata medie de spitalizare a fost de 3.2 zile. În primul an de monitorizare postoperatorie s-au înregistrat doar complicaţii minore, ce au putut fi controlate medical: anemie (6/61), deficit de folaţi (5/61), constipaţie (22/61), căderea părului (12/61). Concluzii: Chirurgia bariatrică şi metabolică este sigură şi eficientă în tratamentul obezităţii la adolescent, atunci când este efectuată în centre cu experienţă. AbstractBackground: Childhood obesity is becoming more frequent and the age of diagnosis has decreased. Although initially sceptic about bariatric surgery in children and adolescents the number of papers to advocate earlier bariatric interventions in this age group is now considerable. However, there are still a lot of controversies about bariatric surgery's indications and long-term results in these patients. Aim/Objective: To analyze the outcomes of bariatric surgery in a group of adolescents with obesity operated in our hospital. Methods: We analyzed retrospectively all the consecutive adolescent patients who underwent laparoscopic gastric sleeve or gastric bypass between 2013 and November 2019 in a Bariatric Center of Excellence, tracking the perioperative morbidity, the changes of BMI and comorbidities at 12 and 36 PO months. Results: Sixty-four adolescent patients were included in the study, 62 with sleeve gastrectomy (SG) and two with gastric bypass (GBP). Mean age at operation was 15 years and 5 months (SD 18 months). Mean BMI before operation was 39.45 kg/m 2 (SD 6.9) and decreased to 24.92 kg/m 2 and 22.7kg/m 2 by 12 and 36 months respectively. There were no major pe...

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