title: Laparoscopic sleeve gastrectomy in adolescents with or without syndromic obesity: two years follow-up.
abstract: BACKGROUND
  Childhood obesity is an emerging health problem. Surgical treatment of obese adolescents, particularly those affected by congenital syndrome, represents a controversial issue. The aim of this multicenter study was to retrospectively assess the results of laparoscopic sleeve gastrectomy (LSG) in a cohort of adolescents affected by morbid obesity, with or without congenital syndromes.
  
  
  METHODS
  Forty-one obese (BMI 49 ± 6 kg/m2) adolescents with mean age of 16 ± 3 years (58.5% with previous intragastric balloon failure), and subjected to LSG, were retrospectively evaluated for complications rate, % excess weight loss (%EWL), and inhibition of co-morbidities after 2 years of follow-up.
  
  
  RESULTS
  All the operations were completed laparoscopically and no intra-operative complications were recorded. No mortality was recorded while peri- or post-operative complications only occurred in two patients (4.9%). The EWL% at 6, 12, and 24 months were 42.3, 58.3, and 59.4, respectively. %EWL was comparable (p = 0.7) between non-syndromic and syndromic obese adolescents at 24 months. Conversely patients with previous intragastric balloon surgery had a significant lower EWL (%) at 24 month (p < 0.01). Moreover, at the same time point, co-morbidity resolution rate was 78.2% while improvement rate was 57.6%. Specifically, remission rate of type 2 diabetes (T2DM), hypertension and obstructive sleep apnea (OSA) were 71, 75 and 61%, respectively.
  
  
  CONCLUSIONS
  LSG is advantageous in the treatment of morbidly obese juveniles concerning safety, weight loss and co-morbidity control and at same time presenting, a possible effective therapeutic option for patients affected by congenital syndrome.
authors.affiliation: Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, "La Sapienza", University of Rome, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Iossa
authors.affiliation: Department of Paediatric Surgery, Hospital Bambino Gesù", Palidoro (Rm), Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Peppo
authors.affiliation: Department of Paediatric Surgery, Hospital Bambino Gesù", Palidoro (Rm), Italy.
authors.forename: Romina
authors.initials: R
authors.lastname: Caccamo
authors.affiliation: Division of General Surgery and Weight LOSS Center, West Chester Hospital, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Brad Michael
authors.initials: BM
authors.lastname: Watkins
authors.affiliation: Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, "La Sapienza", University of Rome, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Abbatini
authors.affiliation: Department of Paediatric Surgery, Hospital Bambino Gesù", Palidoro (Rm), Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Ceriati
authors.affiliation: Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, "La Sapienza", University of Rome, Rome, Italy. gianfranco.silecchia@uniroma1.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Silecchia
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescents; Bariatric surgery in teenagers; Childhood obesity; Sleeve gastrectomy; Surgical treatment; Syndromic obesity