title: Laparoscopic sleeve gastrectomy as first-line surgical treatment for morbid obesity among adolescents.
abstract: BACKGROUND
  The increasing prevalence of obesity has necessitated the increasing use of bariatric surgery in the adolescent population. Outcomes following laparoscopic sleeve gastrectomy (LSG) among adolescents, however, have not been well-studied. We report outcomes following LSG as a first-line surgical therapy in patients under 21years of age.
  
  
  METHODS
  All patients who underwent LSG as a primary surgical option for morbid obesity were identified at the University of Illinois at Chicago between 2006 and 2014. Standard clinicopathologic and outcomes data were recorded.
  
  
  RESULTS
  We identified 18 patients (13 females, 5 males) who underwent LSG. Mean patient age was 17.8±1.7years. Mean BMI among all patients was 48.6±7.2kg/m2and did not differ by gender (P=0.68). One patient (5.6%) experienced a 30-day perioperative complication (pulmonary embolism). Median LOS following LSG was 3days (IQR: 2, 3). 2 patients (11.1%) were readmitted within 30-days because of feeding intolerance that resolved without invasive intervention. At a median follow-up of 10.6 (range: 0-38) months, percent excess weight loss (%EWL) among all patients was 35.6%. Among patients with at least 2years follow-up (n=3), %EWL was 50.2%.
  
  
  CONCLUSIONS
  Laparoscopic sleeve gastrectomy in morbidly obese adolescents is a safe and feasible option. Short- and long-term weight loss appears to be successful following LSG. As such, LSG should be strongly considered as a primary surgical treatment option for all morbidly obese adolescents.
  
  
  METHODS
  Level IV.
authors.affiliation: Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL. Electronic address: aejaz1@gmail.com.
authors.forename: Aslam
authors.initials: A
authors.lastname: Ejaz
authors.affiliation: Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL.
authors.forename: Pankti
authors.initials: P
authors.lastname: Patel
authors.affiliation: Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gonzalez-Heredia
authors.affiliation: University of Illinois College of Medicine at Peoria, Peoria, IL.
authors.forename: Mark
authors.initials: M
authors.lastname: Holterman
authors.affiliation: Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Elli
authors.affiliation: University of Illinois College of Medicine at Peoria, Peoria, IL.
authors.forename: Robert
authors.initials: R
authors.lastname: Kanard
mesh_terms: D000293:Adolescent; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D059035:Perioperative Period; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Adolescents; Gastrectomy; Obesity; Sleeve; Weight loss