title: One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group.
abstract: OBJECTIVE
  Little is known about the metabolic outcomes of adolescent bariatric surgery. We report changes in weight, metabolic profile, and types of complications seen in a multicenter cohort.
  
  
  METHODS
  One-year outcomes were included. For weight loss comparisons, a nonsurgical cohort (n = 12) was used. The primary outcome was weight change (n = 30) and secondary outcomes were metabolic variables (n = 24) and complications (n = 36). Data were analyzed using signed rank or paired t tests.
  
  
  RESULTS
  Mean body mass index fell 37% (from 56.5 preoperatively to 35.8 kg/m2; P < .001) in surgical patients and 3% (from 47.2 to 46 kg/m2; P = NS) in nonsurgical patients. Surgical patients showed significant improvements in triglycerides (-65 mg/dL), total cholesterol (-28 mg/dL), fasting blood glucose (-12 mg/dL), and fasting insulin (-21 microM/mL]). Improvement in high-density lipoprotein cholesterol (-3.9 mg/dL) and low-density lipoprotein cholesterol (-8.8 mg/dL) was not statistically significant. Sixty-one percent of surgical patients had no complications. Of 15 patients with complications, 9 had minor complications with no long-term sequelae, 4 had at least 1 moderate complication with sequelae for at least 1 month and 2 had at least 1 severe medical complication with long-term consequences (including beriberi and death). There were no perioperative deaths or other severe surgical complications in this series.
  
  
  CONCLUSIONS
  Postoperatively, adolescents lose significant weight and realize major metabolic improvements. The complication profile compares favorably to severely obese (body mass index >40 kg/m2) adults; however, small sample size precludes calculation of complication rates. Although there are considerable risks of bariatric surgery, early experience suggests that risks are offset by health benefits.
authors.affiliation: Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45255, USA.
authors.forename: M Louise
authors.initials: ML
authors.lastname: Lawson
authors.forename: Shelley
authors.initials: S
authors.lastname: Kirk
authors.forename: Terry
authors.initials: T
authors.lastname: Mitchell
authors.forename: Mike K
authors.initials: MK
authors.lastname: Chen
authors.forename: Tara Jean
authors.initials: TJ
authors.lastname: Loux
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.forename: Carroll M
authors.initials: CM
authors.lastname: Harmon
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Clements
authors.forename: Victor F
authors.initials: VF
authors.lastname: Garcia
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology / Q000601:surgery; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome; D015431:Weight Loss