A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes.
BACKGROUND AND MATERIALS AND METHODS: The outcome of patients completing 12 months of follow-up in a prospective longitudinal trial of the safety/efficacy of laparoscopic adjustable gastric banding (LAGB) for morbidly obese adolescents aged 14 to 17 years using a Food and Drug Administration Institutional Device Exemption for the use of the LAPBAND was analyzed. Baseline and outcome data were abstracted from a prospective database.


RESULTS
Baseline (mean +/- SD) body mass index was 50 +/- 10 kg/m(2), and excess weight was 178 +/- 53 lb in 20 patients. Comorbidities included hypertension (45%), dyslipidemia (80%), insulin resistance (90%), metabolic syndrome (95%), and biopsy-proven nonalcoholic steatohepatitis (88%). At mean (SD) follow-up of 26 (9) months, % excess weight loss was 34% +/- 22% (n = 20) and 41% +/- 27% (n = 12), and the metabolic syndrome was resolved in 63% and 82% of the patients at 12 and 18 months, respectively. Hypertension normalized in all patients, along with improvement in lipid abnormalities and quality of life scores (P < .05). At 12 months, of the 5 patients with less than 20% excess weight loss, dyslipidemia and metabolic syndrome were resolved in 2 patients.


CONCLUSIONS
At intermediate follow-up of a LAGB-based obesity treatment program, weight loss led to resolution or improvement of major obesity-related comorbidities in most patients, supporting the efficacy of LAGB as a surgical adjunct to a comprehensive obesity treatment program and its long-term evaluation.
Holterman
Ai-Xuan
AX
Department of Pediatrics and Surgery, Section of Pediatric Surgery, Rush University Medical Center, Chicago, IL 60612, USA. ai-xuan_holterman@rush.edu
Browne
Allen
A
Tussing
Lisa
L
Gomez
Sandra
S
Phipps
Amy
A
Browne
Nancy
N
Stahl
Christiane
C
Holterman
Mark J
MJ
D000293:Adolescent; D015992:Body Mass Index; D015897:Comorbidity; D004582:Electronics, Medical / Q000295:instrumentation; D004867:Equipment Design / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000295:instrumentation / Q000379:methods*; D006304:Health Status; D006801:Humans; D010535:Laparoscopy; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000628:therapy*; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration; D015431:Weight Loss