title: Long-term results after laparoscopic adjustable gastric banding in adolescent patients: follow-up of the Austrian experience.
abstract: BACKGROUND
  During the last 30 years a threefold increase in the number of overweight children has been reported in Western countries. More than 15% of adolescents have a body mass index (BMI) higher than the 95th percentile. The use of surgical strategies in adolescent patients is still controversial due to the impact on the continuing maturing process. Laparoscopic adjustable gastric banding (LAGB) is considered a minimal invasive procedure that does not alter the physiological behavior of the bowel and has already shown promising results in short-term studies.
  
  
  METHODS
  Between 1998 and 2004, 50 adolescent patients above the 99.5th age- and gender-adjusted growing percentile were treated with LAGB. The surgical procedure was performed at three highly experienced centers for bariatric surgery. Mean age was 17.1 ± 2.2 years (range = 9-19 years) at the time of surgery. Follow-up investigations were performed in the outpatient clinic of the treating hospitals. Psychological changes were analyzed using the BAROS questionnaire.
  
  
  RESULTS
  The mean BMI decreased from 45.2 ± 7.6 kg/m(2) at the time of surgery to 38.3 ± 6.2 kg/m(2) 1 year after surgery, 31.5 ± 6.6 kg/m(2) after 3 years, and 27.3 ± 5.3 kg/m(2) after 5 years. Mean excessive weight loss was 49.7 ± 29.2, 76.8 ± 27.5, and 92.6 ± 24.5% at 1, 3, and 5 years after surgery. Quality of life showed a further significant improvement between 3 and 5 years after surgery (BAROS: 5.5 ± 1.9 increased to 6.3 ± 2.2, p = 0.01). All preoperative comorbidities resolved in patients with a functional band after 5 years of follow-up.
  
  
  CONCLUSIONS
  LAGB shows promising results in the long-term follow-up with continuous weight loss in patients with a functional band. Nevertheless, most of the weight loss is within the first 3 years after surgery. Thereafter, further weight reduction is about 10% over the following 2 years. Perioperative comorbidities resolve within the first 5 years after treatment.
authors.affiliation: Department of Surgery, Medical University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Gerd R
authors.initials: GR
authors.lastname: Silberhumer
authors.forename: Karl
authors.initials: K
authors.lastname: Miller
authors.forename: Antonia
authors.initials: A
authors.lastname: Pump
authors.forename: Stefan
authors.initials: S
authors.lastname: Kriwanek
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: Georg
authors.initials: G
authors.lastname: Gyoeri
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
mesh_terms: D000293:Adolescent; D001317:Austria; D015992:Body Mass Index; D002648:Child; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D015431:Weight Loss; D055815:Young Adult