Gastric Bypass Surgery in Adolescents With Morbid Obesity

Strauss, RS; Bradley, LJ; Re, Brolin

doi:10.1177/011542650201700143

Cited by 24 publications

(32 citation statements)

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“…However, the majority remain significantly below their presurgery weight, with only 10-20% regaining a significant proportion of their excess weight [28]. After RYGB, weight regain varied between 10 and 15% among adolescent patients in two small studies after 6-12 years, similar to reports of weight regain in adults after gastric bypass [29,30].…”

Section: Controversies In Adolescent Bariatric Surgerysupporting

confidence: 68%

Adolescent Bariatric Surgery: Current Status in an Evolving Field

Luca¹,

Dettmer²,

Langer³

et al. 2015

Metabolic Syndrome and Obesity in Childhood and Adolescence

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Bariatric surgery has been increasingly performed in adolescents over the past decade. Consensus guidelines have been developed to help heath care teams select adolescent candidates for surgery. Reports of short-term outcomes in adolescents have demonstrated similar BMI reduction and safety as in the adult population. There are several issues specific to adolescents that require further consideration, including a lower age limit and BMI at surgery, the optimal choice of bariatric procedure, the potential for the development of disordered eating and weight recidivism after surgery, and the extent of psychological and developmental assessment prior to performing these procedures. With the ongoing increase in the number of adolescent bariatric surgeries performed, it will be essential for high-level evidence with long-term follow-up to be generated to help address these issues and guide health care teams caring for teens with obesity.Bariatric surgery was first performed in adolescents beginning in the late 1970s, and the number of procedures performed has progressively increased over time. Data from the Kids' Inpatient Database [1] suggest that the number of bariatric operations in children and adolescents in the U.S. has doubled from 771 in 2003 to 1,615 in 2009. The increase is likely due to increasing rates of adult bariatric surgery and the knowledge that nonsurgical treatments have a limited effect on children with severe obesity and that, without an effective intervention, the majority of obese adolescents will remain obese in adulthood [2].The most common types of bariatric operations performed in adolescents include Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB), and sleeve gastrectomy (SG) ( fig. 1) [3]. RYGB is both a restrictive and a

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Section: Controversies In Adolescent Bariatric Surgerysupporting

confidence: 68%

Adolescent Bariatric Surgery: Current Status in an Evolving Field

Luca¹,

Dettmer²,

Langer³

et al. 2015

Metabolic Syndrome and Obesity in Childhood and Adolescence

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“…Age was broadly comparable across the remaining three surgery types, with the age at surgery within studies ranging from 5 to 23 years. The majority of patients were operated on between 1996 and 2012 (Table ), although two studies using the RYGB method included operations from before 1986 .…”

Section: Resultsmentioning

confidence: 99%

Bariatric surgery for obese children and adolescents: a systematic review and meta‐analysis

et al. 2013

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The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery. We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in body mass index (BMI) 1-year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL). A systematic literature search (1955-2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model. In total, 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: -13.5 kg m(-2) ; 95% confidence interval [CI] -14.1 to -11.9). Complications were inconsistently reported. There was some evidence of co-morbidity resolution and improvements in HRQol post-surgery. Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents.

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“…Along with the accompanying strict eligibility criteria, most children and adolescents do not even qualify or have accessibility to bariatric surgery . Thus, bariatric surgery is an invasive operation that should be carefully deliberated with families and healthcare professionals . Bariatric surgery should be deemed as a ‘last resort’ option if a trial(s) of lifestyle interventions in a multidisciplinary program(s) have not been successful .…”

Section: Bariatric Surgerymentioning

confidence: 99%