The mini-gastric bypass in the management of morbid obesity in Prader-Willi syndrome: a viable option?
OBJECTIVE
To test the efficacy of the mini-gastric bypass (MGB) in the treatment of morbid obesity related to the Prader-Willi Syndrome (PWS).


METHODS
Three young male patients (mean age 15.6 years) complaining with PWS were treated by MGB with the aim to improve morbid obesity associated with the syndrome. Preoperative body mass index was 51 ± 4.13 kg/m(2). Two patients suffered from both hypertension and frequent sleep apnea crises. The mean preoperative level of fasting plasma acyl ghrelin was 1417.26 ± 289.37 pg/ml. All patients underwent a laparoscopic MGB.


RESULTS
The postoperative period was uneventful and all patients were discharged on the fifth postoperative day. The patients suffering from both hypertension and respiratory crises are now free from receiving any therapeutic support. When measured, the postoperative level of fasting plasma acyl ghrelin decreased to 675.5, 524.6, and 353.1 pg/ml, respectively. An excess weight loss of 79% has been recorded at two years so far. To date, no nutritional impairment, weight regain, or need for revision surgery has been recorded.


CONCLUSIONS
MGB appears to provide an effective weight reduction in patients suffering from PWS without determining significant nutritional impairment or weight regain. Larger studies are however required.
Medical School, Advanced Biomedical Sciences Department, General Surgery, "Federico II" University , Naples , Italy.
Mario
M
Musella
Marco
M
Milone
Maddalena
M
Leongito
Paola
P
Maietta
Paolo
P
Bianco
Anna
A
Pisapia
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015390:Gastric Bypass / Q000379:methods*; D054439:Ghrelin / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011218:Prader-Willi Syndrome / Q000150:complications / Q000601:surgery*; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000628:therapy
D054439:Ghrelin