Laparoscopic adjustable gastric banding in adolescents: Results at two years including psychosocial aspects.
OBJECTIVE
Obesity now affects 3%-4% of the pediatric population and contributes to the increase in cardiac mortality in adulthood. Bariatric surgery is the best treatment for weight loss and the obesity-associated comorbidities in adults. We report here our experience of laparoscopic adjustable gastric banding (LAGB) in adolescents.


METHODS
The medical charts of the first 16 patients operated on in our center were reviewed. Data were compiled concerning weight loss, physical and biological comorbidities, health-related quality of life (QOL) and surgical complications before surgery and during 24months of follow-up.


RESULTS
The maximal pre-operative median body mass index was 43.0kg·m(-2), decreasing to 33.0kg·m(-2) at 2years post-LAGB, which corresponded to a 49.2% excess body weight loss (p<0.001). Most comorbidities (glucose intolerance, hypertension and sleep apnea) resolved within the first year post-LAGB and QOL was improved on the PedsQL™ scales. No severe surgical complications were noted, with only three re-interventions for device failure (2) or band removal (1).


CONCLUSIONS
LAGB is well tolerated in adolescents and shows a beneficial impact on weight loss and obesity-related comorbidities. Associated with global management, it may have a positive impact on patients' QOL and social and psychological status.
Pediatric Surgery Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: FrSchmitt@chu-angers.fr.
Françoise
F
Schmitt
Pediatric Psychiatry Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: Elise.Riquin@chu-angers.fr.
Elise
E
Riquin
Centre de Rééducation des Capucins, 28 Rue des Capucins, B.P. 40329, 49103 Angers Cedex 02, France. Electronic address: marion.beaumesnil@les-capucins-angers.fr.
Marion
M
Beaumesnil
Centre de Rééducation des Capucins, 28 Rue des Capucins, B.P. 40329, 49103 Angers Cedex 02, France. Electronic address: mickael.dinomais@gmail.com.
Mickaël
M
Dinomais
General and Metabolic Surgery Department, Clinique de l'Anjou, 9 Rue de l'Hirondelle, 49000 Angers, France. Electronic address: ptopart@gmail.com.
Philippe
P
Topart
Pediatric Surgery Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: DoWeil@chu-angers.fr.
Dominique
D
Weil
Pediatric Psychiatry Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: JeMalka@chu-angers.fr.
Jean
J
Malka
Pediatric Endocrinology Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: ReCoutant@chu-angers.fr.
Régis
R
Coutant
Pediatric Surgery Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: GuPodevin@chu-angers.fr.
Guillaume
G
Podevin
Pediatric Endocrinology Department, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cedex 9, France. Electronic address: NaBouhours-Nouet@chu-angers.fr.
Natacha
N
Bouhours-Nouet
D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods* / Q000523:psychology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D063766:Pediatric Obesity / Q000150:complications / Q000523:psychology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss
Adolescence; Bariatric surgery; Health-related quality of life; Insulin resistance; LAGB; Morbid obesity