title: Outcomes of bariatric surgery in the young: a single-institution experience caring for patients under 21 years old.
abstract: Medical weight loss options are rarely successful long term in young patients. Bariatric surgery has been shown to be safe and effective in this population.
  
  
  
  Patients ≤21 years old who had bariatric surgery at our institution between January 2009 and December 2013 were evaluated to determine the safety and efficacy of bariatric surgery in this population. The primary end point was excess weight loss (EWL). Secondary end points included surgical morbidity, improvement in obesity-related metabolic parameters, and subjective obesity-related symptoms at 1 year.
  
  
  
  Fifty-four patients were identified who had a laparoscopic Roux-en-Y gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG). Fourteen patients were male (25.9 %), and 40 patients were female (74.1 %). Thirty-seven patients (68.5 %) underwent LGBP, and 17 patients (31.5 %) underwent LSG. Median follow-up was 13.3 months. The baseline BMI was 51.7 kg/m2for the LGBP group and 51.0 kg/m2for the LSG group. EWL was 35.2, 47.6, 62.4, 58.1, and 61.8 % for the LGBP group; 29.7, 44.7, 57.4, 60.3, and 59.0 % for the LSG group at 3, 6, 12, 24, and 36 months, respectively. Our complications included 1 anastomotic bleed, 1 postoperative stricture, and 1 patient who developed vitamin deficiency that manifested as a peripheral neuropathy in the LGBP group. LGBP was more successful than LSG in improving lipid panel parameters and HbA1c at 1 year, and it also seemed to offer better subjective improvement in obesity-related symptoms.
  
  
  
  LGBP and LSG seem to confer comparable weight loss benefit in patients ≤21 years old with acceptable surgical morbidity.
authors.affiliation: Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA. o.k.serrano@gmail.com.|Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA. o.k.serrano@gmail.com.
authors.forename: Oscar K
authors.initials: OK
authors.lastname: Serrano
authors.affiliation: Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Kintzer
authors.affiliation: Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA.|Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Moran-Atkin
authors.affiliation: Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA.|Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Jenny
authors.initials: J
authors.lastname: Choi
authors.affiliation: Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA.|Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: W Scott
authors.initials: WS
authors.lastname: Melvin
authors.affiliation: Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA.|Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Diego R
authors.initials: DR
authors.lastname: Camacho
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy; D001416:Back Pain / Q000628:therapy; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007592:Joint Diseases / Q000628:therapy; D010535:Laparoscopy; D008055:Lipids / Q000097:blood; D008297:Male; D011085:Polycystic Ovary Syndrome / Q000628:therapy; D011184:Postoperative Period; D015431:Weight Loss; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human
keywords: Adolescents; Bariatric surgery; Laparoscopic Roux-en-Y gastric bypass; Laparoscopic sleeve gastrectomy; Morbid obesity; Young adults