Laparoscopic Roux-en-Y gastric bypass in adolescents with morbid obesity--surgical aspects and clinical outcome.
In this paper, we address surgical aspects on bariatric surgery in adolescents from a nationwide Swedish study. Laparoscopic gastric bypass surgery was performed for 81 adolescents with morbid obesity (13-18 years), while 81 adolescents with obesity-matched by age, sex, and BMI received conventional care. Another comparison group was adults undergoing gastric bypass at the same institution during the same time period. This report addresses the 2-year clinical outcome and five-year surgical adverse event rate. Body weight decreased from 133 kg (SD = 22) at inclusion to 92 kg (SD = 17) after 1 year and was 89 (SD = 18) after 2 years (p < 0·001) representing a 32% (-35 to -30) weight loss after 2 years, corresponding to 76% (-81 to -71) excess weight loss. Weight loss was similar in the adult gastric bypass patients (-31%) while weight gain (+3%) was seen in the conventionally treated obese adolescents. Significant improvement in cardiovascular and metabolic risk factors and inflammation was seen after surgery. The treatment was generally well tolerated and quality of life improved significantly. The surgical adverse events included cholecystectomies (10%) and operations for internal hernia (9%) but no postoperative mortality. Adolescents undergoing laparoscopic gastric bypass surgery achieve similar weight loss to adults. Improvements in risk factors and quality of life were substantial. There were surgical complications similar to the adult group, which may be preventable.
Department of Surgery, Medicine and Pediatrics, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, and Centre of Obesity at the Queen Silvia Children's Hospital, Gothenburg, Sweden.
Gunnar
G
Göthberg
Department of Surgery, Medicine and Pediatrics, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, and Centre of Obesity at the Queen Silvia Children's Hospital, Gothenburg, Sweden.
Eva
E
Gronowitz
Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden.
Carl-Erik
CE
Flodmark
Department of Surgery, Medicine and Pediatrics, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, and Centre of Obesity at the Queen Silvia Children's Hospital, Gothenburg, Sweden.
Jovanna
J
Dahlgren
Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Division of Paediatrics, and National Childhood Obesity Centre, Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Kerstin
K
Ekbom
Department of Surgery, Medicine and Pediatrics, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, and Centre of Obesity at the Queen Silvia Children's Hospital, Gothenburg, Sweden.
Staffan
S
Mårild
Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Division of Paediatrics, and National Childhood Obesity Centre, Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Claude
C
Marcus
Department of Surgery, Medicine and Pediatrics, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, and Centre of Obesity at the Queen Silvia Children's Hospital, Gothenburg, Sweden. Electronic address: torsten.olbers@gu.se.
Torsten
T
Olbers
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009767:Obesity, Morbid / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D063766:Pediatric Obesity / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs
Adolescent; Bariatric; Gastric bypass; Surgery