title: Bariatric surgery in adolescents and young adults--safety and effectiveness in a cohort of 345 patients.
abstract: OBJECTIVE
  To examine the safety and effectiveness of adolescent bariatric surgery and to improve treatment recommendations for this age group.
  
  
  METHODS
  Prospective longitudinal registry. Since January 2005, patients undergoing bariatric surgery in Germany are enlisted in an online registry called 'study for quality assurance in obesity surgeries'.
  
  
  METHODS
  Adolescents and young adults up to the age of 21 years, operated from January 2005 to December 2010.
  
  
  METHODS
  Weight, BMI, comorbidities, complication rates.
  
  
  RESULTS
  N=345 primary procedures were recorded by 58 hospitals. N=51 patients were under the age of 18 years. Follow-up information was available for 48% (n=167) of patients, with an average observation period of 544±412 days (median: 388 days). The most common surgical techniques were gastric banding (n=118, 34.2%), gastric bypass (n=116, 33.6%) and sleeve gastrectomy (n=78, 22.6%). Short-term complications (intra-operative; general postoperative; specific postoperative) were slightly lower for gastric banding (0.8%; 2.5%; 0.8%) than for gastric bypass (2.6%; 5.2%; 1.7%) or sleeve gastrectomy (0%; 9.0%; 7.7%). In accordance with published findings, weight and BMI reduction were lower for gastric banding (-28 kg; -9.5 kg m(-2)) compared to gastric bypass (-50 kg; -16.4 kg m(-2)) P< 0.001 or sleeve gastrectomy (-46 kg; -15.4 kg m(-2)) P< 0.001. Outcomes did not differ between the <18 and ≥18-year-old patients.
  
  
  CONCLUSIONS
  Like in adults, bariatric surgery has low short-term complication rates and results in sustained weight loss in adolescents. However, the missing long-term observations prohibit a final conclusion about lasting effectiveness and safety. Clinical trials with structured follow-up programs and mechanisms to ascertain patient adherences are needed.
authors.affiliation: Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University Medical Center, Ulm, Germany.
authors.forename: B S
authors.initials: BS
authors.lastname: Lennerz
authors.affiliation: Division of Pediatric Endocrinology and Diabetes, Interdisciplinary Obesity Unit, Department of Pediatrics and Adolescent Medicine, University Medical Center, Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wabitsch
authors.affiliation: 1] University Hospital for General-, Visceral-, and Vascular Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany [2] Institute for Quality Assurance in Surgical Medicine at the University Hospital, Magdeburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lippert
authors.affiliation: University Hospital for General-, Visceral-, and Vascular Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wolff
authors.affiliation: StatConsult Magdeburg, Research Institute for Clinical Research and Development, Magdeburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Knoll
authors.affiliation: Krankenhaus Sachsenhausen, Frankfurt.
authors.forename: R
authors.initials: R
authors.lastname: Weiner
authors.affiliation: 1] Institute for Quality Assurance in Surgical Medicine at the University Hospital, Magdeburg, Germany [2] SRH Hospital for General, Visceral, and Pediatric Surgery, Wald-Klinikum Gera, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Manger
authors.affiliation: Hospital for Children and Adolescents, Center of Pediatric Research, Leipzig, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Kiess
authors.affiliation: 1] Institute for Quality Assurance in Surgical Medicine at the University Hospital, Magdeburg, Germany [2] SRH Hospital for General, Visceral, and Pediatric Surgery, Wald-Klinikum Gera, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Stroh
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects; D015390:Gastric Bypass / Q000009:adverse effects; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011446:Prospective Studies; D012042:Registries; D012074:Remission Induction / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
references.citation: J Pediatr. 2007 Jan;150(1):12-17.e2
references.pmid: 17188605
references.citation: Drugs. 2010 Feb 12;70(3):335-46
references.pmid: 20166770
references.citation: J Pediatr. 2010 Jan;156(1):103-108.e1
references.pmid: 19775700
references.citation: Int J Pediatr Obes. 2011 Sep;6 Suppl 1:65-9
references.pmid: 21905819
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011 May;54(5):577-83
references.pmid: 21547649
references.citation: Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):489-96
references.pmid: 16778582
references.citation: Ann Intern Med. 2007 Jul 3;147(1):41-50
references.pmid: 17606960
references.citation: MCN Am J Matern Child Nurs. 2013 Jan-Feb;38(1):6-7
references.pmid: 23232772
references.citation: J Pediatr. 2003 Oct;143(4):500-5
references.pmid: 14571229
references.citation: Obes Surg. 2009 Jan;19(1):105-12
references.pmid: 18941846
references.citation: Obesity (Silver Spring). 2010 Aug;18(8):1572-8
references.pmid: 20057376
references.citation: Surg Obes Relat Dis. 2012 Jan-Feb;8(1):1-7
references.pmid: 22030146
references.citation: J Pediatr Surg. 2008 Jan;43(1):141-6
references.pmid: 18206472
references.citation: J Pediatr Surg. 2010 Jan;45(1):74-8; discussion 78-9
references.pmid: 20105583
references.citation: JAMA. 2003 Jan 8;289(2):187-93
references.pmid: 12517229
references.citation: JAMA Pediatr. 2013 Feb;167(2):126-32
references.pmid: 23247297
references.citation: J Clin Med Res. 2010 May 19;2(3):105-11
references.pmid: 21629521
references.citation: Ann Surg. 2008 Nov;248(5):763-76
references.pmid: 18948803
references.citation: J Am Coll Surg. 2008 Jan;206(1):1-12
references.pmid: 18155562
references.citation: Pediatrics. 2004 Jul;114(1):217-23
references.pmid: 15231931
references.citation: JAMA. 2007 Oct 10;298(14):1661-73
references.pmid: 17925518
references.citation: Child Adolesc Psychiatr Clin N Am. 2009 Jan;18(1):49-65
references.pmid: 19014857
references.citation: J Pediatr Surg. 2007 Jan;42(1):137-41; discussion 141-2
references.pmid: 17208554
references.citation: Ann Intern Med. 2005 Jan 4;142(1):56-66
references.pmid: 15630109
references.citation: Pediatrics. 2009 Jan;123(1):214-22
references.pmid: 19117885
references.citation: N Engl J Med. 2007 Aug 23;357(8):753-61
references.pmid: 17715409
references.citation: Health Technol Assess. 2009 Sep;13(41):1-190, 215-357, iii-iv
references.pmid: 19726018
references.citation: Obesity (Silver Spring). 2012 Feb;20(2):318-23
references.pmid: 21996668
references.citation: JAMA. 2005 Jun 15;293(23):2873-83
references.pmid: 15956632
references.citation: Pediatr Clin North Am. 2011 Dec;58(6):1393-401, x
references.pmid: 22093858
references.citation: J Pediatr. 2005 Jul;147(1):10-9
references.pmid: 16027686
references.citation: N Engl J Med. 2004 Jun 3;350(23):2362-74
references.pmid: 15175438
references.citation: J Pediatr. 2011 Aug;159(2):303-7
references.pmid: 21429506
references.citation: J Pediatr Surg. 2007 Nov;42(11):1969-71
references.pmid: 18022459
references.citation: Surg Obes Relat Dis. 2011 Nov-Dec;7(6):727-32
references.pmid: 21497142
references.citation: J Pediatr. 2005 Oct;147(4):443-50
references.pmid: 16227028
references.citation: Surg Obes Relat Dis. 2011 Nov-Dec;7(6):720-6
references.pmid: 21429814
references.citation: N Engl J Med. 2011 Oct 13;365(15):1365-7
references.pmid: 21995381
references.citation: N Engl J Med. 2007 Aug 23;357(8):741-52
references.pmid: 17715408
references.citation: JAMA. 2003 Apr 9;289(14):1805-12
references.pmid: 12684359
references.citation: Pediatrics. 2011 Sep;128 Suppl 2:S65-70
references.pmid: 21885647
references.citation: Int J Obes. 1989;13(2):123-36
references.pmid: 2663745
references.citation: Obesity (Silver Spring). 2009 Jun;17(6):1196-9
references.pmid: 19584877
references.citation: Surg Obes Relat Dis. 2007 Jul-Aug;3(4):465-8
references.pmid: 17400517
references.citation: N Engl J Med. 2004 Dec 23;351(26):2683-93
references.pmid: 15616203
references.citation: Int J Obes (Lond). 2007 Jan;31(1):1-14
references.pmid: 17173060
references.citation: Pediatrics. 2006 Apr;117(4):1155-61
references.pmid: 16585310
references.citation: Obes Facts. 2009;2 Suppl 1:2-7
references.pmid: 20124768
references.citation: Obes Surg. 2010 Dec;20(12):1609-16
references.pmid: 20835899
references.citation: J Pediatr. 1996 May;128(5 Pt 1):608-15
references.pmid: 8627431
references.citation: Obes Surg. 2012 Sep;22(9):1445-9
references.pmid: 22638680
references.citation: Zentralbl Chir. 2013 Apr;138(2):180-8
references.pmid: 22753146
references.citation: Eur J Pediatr. 2004 Feb;163(2):99-104
references.pmid: 14691718
references.citation: Eur J Pediatr Surg. 2011 Oct;21(5):331-4
references.pmid: 21842461
references.citation: JAMA. 2007 Jun 27;297(24):2697-704
references.pmid: 17595270
references.citation: N Engl J Med. 2010 Feb 11;362(6):485-93
references.pmid: 20147714
references.citation: Ann Surg. 2011 Sep;254(3):410-20; discussion 420-2
references.pmid: 21865942
references.citation: Int J Pediatr Obes. 2008;3 Suppl 1:78-82
references.pmid: 18278637
references.citation: Int J Obes Relat Metab Disord. 2003 Dec;27(12):1459-64
references.pmid: 14634675
references.citation: J Gastrointest Surg. 2003 Jan;7(1):102-108
references.pmid: 12559191