title: Efficacy and safety of bariatric surgery for craniopharyngioma-related hypothalamic obesity: a matched case-control study with 2 years of follow-up.
abstract: Hypothalamic obesity is a devastating consequence of craniopharyngioma. Bariatric surgery could be a promising therapeutic option. However, its efficacy and safety in patients with craniopharyngioma-related hypothalamic obesity remain largely unknown.
  
  
  
  We investigated the efficacy of bariatric surgery for inducing weight loss in patients with craniopharyngioma-related hypothalamic obesity. In addition, we studied the safety of bariatric surgery regarding its effects on hormone replacement therapy for pituitary insufficiency.
  
  
  
  In this retrospective matched case-control study, we compared weight loss after bariatric surgery (that is, Roux-en-Y gastric bypass and sleeve gastrectomy) between eight patients with craniopharyngioma-related hypothalamic obesity and 75 controls with 'common' obesity during 2 years of follow-up. We validated our results at 1 year of follow-up in a meta-analysis. In addition, we studied alterations in hormone replacement therapy after bariatric surgery in patients with craniopharyngioma.
  
  
  
  Mean weight loss after bariatric surgery was 19% vs 25% (difference -6%, 95% confidence of interval (CI) -14.1 to 4.6; P=0.091) at 2 years of follow-up in patients with craniopharyngioma-related hypothalamic obesity compared with control subjects with 'common' obesity. Mean weight loss was 25% vs 29% (difference -4%, 95% CI -11.6 to 8.1; P=0.419) after Roux-en-Y gastric bypass and 10% vs 20% (difference -10%, 95% CI -14.1 to -6.2; P=0.003) after sleeve gastrectomy at 2 years of follow-up in patients with craniopharyngioma-related hypothalamic obesity vs control subjects with 'common' obesity. Our meta-analysis demonstrated significant weight loss 1 year after Roux-en-Y gastric bypass, but not after sleeve gastrectomy. Seven patients with craniopharyngioma suffered from pituitary insufficiency; three of them required minor adjustments in hormone replacement therapy after bariatric surgery.
  
  
  
  Weight loss after Roux-en-Y gastric bypass, but not sleeve gastrectomy, was comparable between patients with craniopharyngioma-related hypothalamic obesity and control subjects with 'common' obesity at 2 years of follow-up. Bariatric surgery seems safe regarding its effects on hormone replacement therapy.
authors: Department of Paediatric Oncology and Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.|Section Endocrinology, Department of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors: M
authors: M
authors: Wijnen
authors: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: D S
authors: DS
authors: Olsson
authors: Department of Paediatric Oncology and Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.|Princess Maxima Centre for Paediatric Oncology, Utrecht, The Netherlands.
authors: M M
authors: MM
authors: van den Heuvel-Eibrink
authors: Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: V
authors: V
authors: Wallenius
authors: Section Endocrinology, Department of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors: J A M J L
authors: JA
authors: Janssen
authors: Section Endocrinology, Department of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors: P J D
authors: PJ
authors: Delhanty
authors: Section Endocrinology, Department of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors: A J
authors: AJ
authors: van der Lely
authors: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: G
authors: G
authors: Johannsson
authors: Department of Paediatric Oncology and Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.|Section Endocrinology, Department of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors: S J C M M
authors: SJ
authors: Neggers
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000209:etiology* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult