title: Laparoscopic Adjustable Gastric Banding in Australian Adolescents: Should It Be Done?
abstract: There are very few studies on laparoscopic adjustable gastric banding (LAGB) in obese adolescents with follow up for more than 36 months, let alone good prospective data beyond 24 months in Australian adolescents. We aimed to evaluate medium term (>36 months) safety and efficacy of LAGB in adolescents with severe obesity.
  
  
  
  This is a prospective cohort study (March 2009-December 2015) in one tertiary referral hospital including obese adolescents (14-18 years) with a body mass index (BMI) >40 (or ≥35 with comorbidities) who consented to have LAGB. Exclusion criteria were syndromal causes of obesity, depression and oesophageal motility disorders. Main outcome measures include change in weight and BMI at 6, 12, 24, 36 and 48 months post LAGB; postoperative complications; and admissions.
  
  
  
  Twenty-one adolescents (median [interquartile range (IQR)] 17.4 [16.5-17.7] years, 9 males, mean ± SD BMI 47.3 ± 8.4 kg/m2) had a median follow up of 45.5 [32-50] months post LAGB. Follow up data were available for 16 adolescents. Weight and BMI improved significantly at all follow up times (all p < 0.01). The median maximum BMI loss was 10 [7.1-14.7] kg/m2. There were four minor early complications. Seven bands were removed due to weight loss failure/regain (two had also obstructive symptoms).
  
  
  
  We have shown in the longest prospective LAGB postoperative follow up study of Australian adolescents that LAGB improves BMI in the majority of adolescents without significant comorbidities. LAGB is still a reasonable option to be considered as a temporary procedure to manage severe obesity during adolescence.
authors.affiliation: Robinson Research Institute and Discipline of Paediatrics, The University of Adelaide, Adelaide, South Australia, Australia. alexia.pena@adelaide.edu.au.|Endocrinology and Diabetes Department, Women's and Children's Hospital (WCH), North Adelaide, South Australia, Australia. alexia.pena@adelaide.edu.au.
authors.forename: Alexia Sophie
authors.initials: AS
authors.lastname: Peña
authors.affiliation: Department of Gastrointestinal Surgery, Flinders Medical Centre, Adelaide, Australia. tarik.delko@gmail.com.
authors.forename: Tarik
authors.initials: T
authors.lastname: Delko
authors.affiliation: Gastroenterology Department, Women's and Children's Hospital (WCH), North Adelaide, South Australia, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Couper
authors.affiliation: Department of Gastrointestinal Surgery, Flinders Medical Centre, Adelaide, Australia.
authors.forename: Kerri
authors.initials: K
authors.lastname: Sutton
authors.affiliation: Gastroenterology Department, Women's and Children's Hospital (WCH), North Adelaide, South Australia, Australia.
authors.forename: Stamatiki
authors.initials: S
authors.lastname: Kritas
authors.affiliation: Gastroenterology Department, Women's and Children's Hospital (WCH), North Adelaide, South Australia, Australia.|Human Physiology, Medical Science and Technology, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Taher
authors.initials: T
authors.lastname: Omari
authors.affiliation: Department of Gastrointestinal Surgery, Flinders Medical Centre, Adelaide, Australia.
authors.forename: Jacob
authors.initials: J
authors.lastname: Chisholm
authors.affiliation: Department of Gastrointestinal Surgery, Flinders Medical Centre, Adelaide, Australia.
authors.forename: Lilian
authors.initials: L
authors.lastname: Kow
authors.affiliation: Robinson Research Institute and Discipline of Paediatrics, The University of Adelaide, Adelaide, South Australia, Australia.|Paediatric Surgery, Women's and Children's Hospital (WCH), North Adelaide, South Australia, Australia.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Khurana
mesh_terms: D000293:Adolescent; D001315:Australia; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Adolescents; Bariatric surgery; Lap band; Longitudinal study; Obese