title: Perioperative Course, Weight Loss and Resolution of Comorbidities After Primary Sleeve Gastrectomy for Morbid Obesity: Are There Differences Between Adolescents and Adults?
abstract: Morbid obesity in both adolescents and adults has risen in an alarming rate. Bariatric surgery is playing an increasing role in pediatric surgery. However, current evidence is limited regarding its safety and outcome.
  
  
  
  Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered. For the current analysis, all adolescent and adult subjects that had undergone laparoscopic sleeve gastrectomy (LSG) from 2005 to 2014 were considered.
  
  
  
  LSG represents the most common bariatric procedure in Germany with a proportion of 48.1% in adolescent and 48.7% in adult obese in 2014. LSG was performed in 362 adolescent and 15,428 adult subjects. Pre-operative BMI was comparable between the two populations. However, adult obese had more frequently coexisting comorbidities (p < 0.01). Complication rates and mortality (0 vs. 0.2%) did not differ significantly. Adolescents achieved a BMI reduction of 16.8 and 18.0 kg/m2at 12 and 24 months compared with 15.4 and 16.6 kg/m2in the adult group. There was a significantly higher BMI reduction in late adolescents (19-21 years) compared with patients ≤18 years at 24 months (19.8 vs. 13.6 kg/m2). Resolution rate of hypertension was significantly higher in adolescents.
  
  
  
  LSG is a safe therapeutic option that can be performed in adolescents without mortality. Late adolescents experienced the highest weight loss; resolution rate of comorbidities was lower in adults. All future efforts should now be focused on the evaluation of the long-term outcomes of LSG in the pediatric population.
authors.affiliation: Department of Surgery, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany. frankbenedix@gmx.de.
authors.forename: Frank
authors.identifier: 0000-0002-5404-6616
authors.initials: F
authors.lastname: Benedix
authors.affiliation: Department of Surgery, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Krause
authors.affiliation: StatConsult Magdeburg, Halberstädter Strasse 40a, 39112, Magdeburg, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Adolf
authors.affiliation: Department of Surgery, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Wolff
authors.affiliation: Department of Surgery, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Lippert
authors.affiliation: SRH Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Manger
authors.affiliation: SRH Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Stroh
mesh_terms: D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D015897:Comorbidity; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D011446:Prospective Studies; D055815:Young Adult
keywords: Adolescents; Adults; German multicenter trial; Obesity; Sleeve gastrectomy