title: Clinical review: Bariatric surgery following treatment for craniopharyngioma: a systematic review and individual-level data meta-analysis.
abstract: OBJECTIVE
  Craniopharyngiomas are rare low-grade tumors located in the hypothalamic and/or pituitary region. Hypothalamic involvement and treatment resulting in hypothalamic damage are known to lead to development of "hypothalamic obesity" (HyOb) in 50% of cases. The management of HyOb, associated with eating disorders and rapid comorbidities, is an important issue. Bariatric surgery is the most effective therapy for weight loss in patients with severe exogenous obesity. The aim of this systematic review and meta-analysis was to determine the 12-month outcome of bariatric surgery for HyOb due to craniopharyngioma treatment.
  
  
  RESULTS
  Relevant studies were identified by searches of the MEDLINE and EMBASE databases until January 2013. A total of 21 cases were included: 6 with adjustable gastric banding, 8 with sleeve gastrectomy, 6 with Roux-en-Y gastric bypass, and 1 with biliopancreatic diversion. After data pooling, mean weight difference was -20.9 kg after 6 months (95% confidence interval [CI], -35.4, -6.3) and -15.1 kg after 12 months (95% CI, -31.7, +1.4). The maximal mean weight loss was achieved by the gastric bypass group: -31.0 kg (95% CI, -77.5, +15.5) and -33.7 kg (95% CI, -80.7, +13.3) after 6 and 12 months, respectively.
  
  
  CONCLUSIONS
  In this largest ever published study on the effect of bariatric surgery on obesity after craniopharyngioma treatment, we observed an important weight loss after 1 year of follow-up. Larger studies are warranted to establish appropriate selection criteria and the best surgical technique to perform bariatric surgery.
authors.affiliation: Department of Nutrition, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Bretault
authors.forename: Adrien
authors.initials: A
authors.lastname: Boillot
authors.forename: Ludivine
authors.initials: L
authors.lastname: Muzard
authors.forename: Christine
authors.initials: C
authors.lastname: Poitou
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.forename: Charles
authors.initials: C
authors.lastname: Barsamian
authors.forename: Blandine
authors.initials: B
authors.lastname: Gatta
authors.forename: Herman
authors.initials: H
authors.lastname: Müller
authors.forename: Dirk
authors.initials: D
authors.lastname: Weismann
authors.forename: Diane
authors.initials: D
authors.lastname: Rottembourg
authors.forename: Thomas
authors.initials: T
authors.lastname: Inge
authors.forename: Nicolas
authors.initials: N
authors.lastname: Veyrie
authors.forename: Claire
authors.initials: C
authors.lastname: Carette
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
mesh_terms: D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000628:therapy*; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000209:etiology / Q000601:surgery*; D008297:Male; D009765:Obesity / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000628:therapy*; D015431:Weight Loss