title: Trends and outcomes of adolescent bariatric surgery in California, 2005-2007.
abstract: OBJECTIVE
  The goal of this study was to evaluate trends, and outcomes of adolescents who undergo bariatric surgery.
  
  
  METHODS
  Patients younger than 21 years who underwent elective bariatric surgery between 2005 and 2007 were identified from the California Office of Statewide Health Planning and Development database. Multivariate logistic regression was used to identify factors associated with the type of surgery.
  
  
  RESULTS
  Overall, 590 adolescents (aged 13-20 years) underwent bariatric surgery in 86 hospitals. White adolescents represented 28% of those who were overweight but accounted for 65% of the procedures. Rates of laparoscopic adjustable gastric banding (LAGB) increased 6.9-fold from 0.3 to 1.5 per 100,000 population (P<.01), whereas laparoscopic Roux-en-Y gastric bypass (LRYGB) rates decreased from 3.8 to 2.7 per 100 000 population (P<.01). Self-payers were more likely to undergo LAGB (relative risk [RR]: 3.51 [95% confidence interval: 2.11-5.32]) and less likely to undergo LRYGB (RR: 0.45 [95% confidence interval: 0.33-0.58]) compared with privately insured adolescents. The rate of major in-hospital complication was 1%, and no deaths were reported. Of the patients who received LAGB, 4.7% had band revision/removal. In contrast, 2.9% of those who received LRYGB required reoperations.
  
  
  CONCLUSIONS
  White adolescent girls disproportionately underwent bariatric surgery. Although LAGB has not been approved by the US Food and Drug Administration for use in children, its use has increased dramatically. There was a complication rate and no deaths. Long-term studies are needed to fully assess the efficacy, safety, and health care costs of these procedures in adolescents.
authors.affiliation: Department of Surgery, UCLA School of Medicine, and UCLA Fit for Health Weight Program, Mattel Children's Hospital UCLA, Division of Pediatric Surgery, UCLA Medical Center, 10833 Le Conte Ave, CHS Building, MC 709818, Los Angeles, CA 90095, USA.
authors.forename: Howard C
authors.initials: HC
authors.lastname: Jen
authors.forename: Diana G
authors.initials: DG
authors.lastname: Rickard
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Shew
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Maggard
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Slusser
authors.forename: Erik P
authors.initials: EP
authors.lastname: Dutson
authors.forename: Daniel A
authors.initials: DA
authors.lastname: DeUgarte
mesh_terms: D000293:Adolescent; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D002140:California / Q000453:epidemiology; D005260:Female; D015390:Gastric Bypass / Q000639:trends; D015391:Gastroplasty / Q000639:trends; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult