title: Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years.
abstract: OBJECTIVE
  To report experience with laparoscopic sleeve gastrectomy (LSG) in 108 severely obese children and adolescents.
  
  
  BACKGROUND
  Obesity during childhood and adolescence can be accompanied by serious long-term adverse health and longevity outcomes. With increased use of bariatric surgery to treat obesity in these patients, diverse guidelines have been published, most of which exclude children aged younger than 14 years. Few reports describe LSG in children and adolescents, delaying determining its safety and effectiveness and developing guidance regarding its use.
  
  
  METHODS
  A retrospective review of LSG performed from March 2008 through February 2011 by a single surgeon at King Saud University Hospitals, Riyadh, Saudi Arabia, included 108 patients aged 5 through 21 years.
  
  
  RESULTS
  Patients attending follow-up visits at 3 (n = 88), 6 (n = 76), 12 (n = 41), and 24 (n = 8) months postoperatively experienced median excess weight loss (EWL) of 28.9%, 48.1%, 61.3%, and 62.3%, respectively. At 6 and 12 months follow-up, 42.1% (n = 32) and 73.2% (n = 30) of patients achieved at least 50% EWL, whereas 7.9% (n = 6) and 4.9% (n = 2) had 25% or less EWL, respectively. There were no serious postoperative complications and no adverse sequelae developed during the current follow-up. Available comorbidity data indicate resolution of dyslipidemia, 21 of 30 (70.0%); hypertension, 27 of 36 (75.0%); prehypertension, 15 of 18 (83.3%); symptoms of obstructive sleep apnea, 20 of 22 (90.9%); diabetes, 15 of 16 (93.8%); and prediabetes, 11 of 11 (100.0%).
  
  
  CONCLUSIONS
  LSG resulted in successful short-term weight loss in more than 90% of pediatric patients and 70% or more comorbidity resolution during up to 24 months of follow-up. Long-term data are necessary to evaluate persistence of weight loss and maturation to adulthood.
authors.affiliation: Department of Biostatistics, Obesity Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia. qahtani@yahoo.com
authors.forename: Aayed R
authors.initials: AR
authors.lastname: Alqahtani
authors.forename: Belavendra
authors.initials: B
authors.lastname: Antonisamy
authors.forename: Hussam
authors.initials: H
authors.lastname: Alamri
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elahmedi
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Zimmerman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D015431:Weight Loss; D055815:Young Adult