Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents.
OBJECTIVE
Obesity has contributed significantly to morbidity and premature deaths in the adolescent population. Because many patients do not respond to dietary modification, exercise regimens, or pharmacologic treatment, weight reduction surgery has become a viable alternative, although the morbidity of conventional gastric bypass has tempered enthusiasm for this approach. Experience with the laparoscopic approach has not been reported previously. The authors examined the outcome of adolescents undergoing laparoscopic Roux-En-Y gastric bypass (lap RYGB).


METHODS
Medical records of patients less than 20 years of age (n = 4; 3 girls, 1 boy) who had undergone lap RYGB for morbid obesity were reviewed. All patients met National Institute of Health criteria for bariatric surgery. Outcome variables examined included weight; body mass index (BMI); hospital length of stay (LOS); comorbid conditions; and tolerance of a regular diet. Mean time to follow-up was 17 months.


RESULTS
All procedures were completed laparoscopically. There were no complications. The average LOS was 2 days. Patients with greater than 20-month follow-up lost an average of 87% of their excess body weight and had nearly complete resolution of comorbidities (including hypertriglyceridemia, hypercholesterolemia, asthma, and gastroesophageal reflux disease).


CONCLUSIONS
Laparoscopic gastric bypass is a safe alternative in morbidly obese adolescents who have not responded to medical therapy.
Stanford
Ala
A
Department of Surgery, Minimally Invasive Surgery Center, Children's Hospital of Pittsburgh and the University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Glascock
John Matthew
JM
Eid
George M
GM
Kane
Timothy
T
Ford
Henri R
HR
Ikramuddin
Sayeed
S
Schauer
Philip
P
D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001249:Asthma / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss