Abstract
Introduction: Children all over the world are increasingly becoming overweight and obese. The experience
with adults has demonstrated that surgery is the only effective way of achieving sustained
weight loss in obese patients. Simultaneously, it has been proposed that bariatric
surgery in the adolescent period would be a more effective treatment for childhood-onset
extreme obesity rather than delaying surgery for extremely obese youth until adulthood.
Nevertheless, the optimal surgical option for both adults and adolescents has yet
to be established. The aim of our study was to evaluate the results of 9 years of
laparoscopic adjusted gastric banding (LAGB) performed in our hospital for obesity-associated
comorbities (OAC), weight loss and surgical morbidity.
Methods: A prospective study of all patients who underwent LAGB at our hospital between July
2001 and May 2010 was carried out. Patient selection was by a multidisciplinary team
and based on the “IPEG Guideline for the Surgical Treatment of Extremely Obese Adolescents”.
Data were reviewed retrospectively.
Results: 14 patients underwent LAGB (10♀; 4♂; average age: 16 years). Preoperative BMI ranged
between 41.4 and 54.6 kg/m2. Prior to surgery, 8 different OACs were identified. 6 months later, 4 types of OAC
had resolved completely and the other 4 had improved, and the improvement was maintained
over time. The average excess weight (EW) loss increased from 25.7 to 48.2% at 6 and
36 months of follow-up, respectively (10 patients). At 60 and 106 months of follow-up
it was 41.5% (5 patients) and 31.8% (1 patient), respectively. There were no complications
arising from the surgery itself. Long-term complications were few and easily managed.
Conclusions: LAGB seems to be a good option to treat obese adolescents, as it is a minimally invasive
procedure that does not radically change the patient's anatomy and is associated with
minimal morbidity. It leads to a sustained improvement/resolution of OAC, and although
weight loss is not continuous, it is maintained over time.
Key words
LAGB - obesity - weight loss - adolescents
References
- 1
Sugerman HJ, Sugerman EL, DeMaria EJ. et al .
Bariatic surgery for severely obese adolescents.
J Gastrointest Surg.
2003;
7
(1)
102-107
- 2
Pratt JSA, Lenders CM, Dionne EA. et al .
Best practice updates for pediatric/adolescent weight loss surgery.
Obesity.
2009;
17
(5)
901-910
- 3
Lobstein T, Rigby N, Leach R.
Obesity in Europe – 3rd International Obesity Task Force, March 2005.
http://www.iotf.org/media/euobesity3.pdf
- 4
Inge TH, Xanthakos SA, Zeller MH.
Bariatric surgery for pediatric extreme obesity: now or later?.
Int J of Obes.
2007;
31
1-14
- 5
Scott Jr HW, Law DH.
Clinical appraisal of jejunoileal shunt in patients with morbid obesity.
Am J Surg.
1969;
117
246-253
- 6
Randolph JG, Weintraub WH, Rigg A.
Jejunoileal bypass for morbid obesity in adolescents.
J Pediatric Surg.
1974;
9
341-345
- 7
Holterman A, Browne A, Tussing L. et al .
A prospective trial for laparoscopic adjustable banding in morbidly obese adolescents:
an interim report of weight loss, metabolic and quality of life outcomes.
J Pediatric Surg.
2010;
45
74-79
Correspondence
Dr. Angelica Osorioresident
Centro Hospitalar do
Porto-Unidade Maria Pia
Department of Pediatric Surgery
rua da boavista 827
4050-110 Oporto
Portugal
Phone: + 351/22/6089 900
Fax: + 351/22/6000 841
Email: angelicosorio@gmail.com
