Laparoscopic Sleeve Gastrectomy in Children Younger Than 14 Years: Refuting the Concerns.
OBJECTIVE
To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on growth in children younger than 14 years in a matched control study.


BACKGROUND
Debatable concerns result in denying young children access to bariatric surgery.


METHODS
Our multidisciplinary program database was used to extract data of young nonsyndromic children (age ≤14 years) who underwent LSG. Patients were age, sex, and height z-score matched with those on nonsurgical weight management, and their results were compared with those of older adolescents (age > 14 years) who underwent LSG. Generalized estimating equation analysis was done to assess growth.


RESULTS
One hundred sixteen children younger than 14 years (mean ± SD, 11.2 ± 2.5 years) underwent LSG. Compared with the 1:1 matched group of nonsurgical weight management, these children experienced significantly higher growth, gaining 0.9 mm more per month on average. Compared with 158 adolescents (age, 17.3 ± 2.0 years) who underwent LSG in our institution, children younger than 14 years had a significantly lower prevalence of comorbidities (P < 0.001) but similar resolution rates (P = 0.72-0.99). There was no significant difference in the rate of complications (P = 0.77), and no mortality or significant morbidity was observed in any of the groups.


CONCLUSIONS
This study challenges existing concerns regarding the safety and efficacy of bariatric surgery in prepubertal children. LSG is evidently safe and effective in this age group, resulting in significant weight loss, improved growth, and resolution of comorbidities without mortality or significant morbidity.
Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Aayed
A
Alqahtani
Mohamed
M
Elahmedi
Awadh R Al
AR
Qahtani
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D016555:Matched-Pair Analysis; D063766:Pediatric Obesity / Q000601:surgery* / Q000628:therapy; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult