Abstract
We have done gastric bypass surgery on 10 morbidly obese adolescents, three of whom also had P-W syndrome. Surgical criteria included a weight > 200% of ideal body weight for height (IBW), significant morbidity from the disease such as hypertension, diabetes or Pickwickian syndrome, and failure of medical therapy. No acute surgical morbidity occurred. One patient has been lost to followup. Two P-W patients have plateaued after losing 49.7 kg and 25.9 kg. One P-W patient has regained the 20 kg he lost after surgery. The mean degree of obesity in the P-W patients decreased from 261% to 206% IBW, whereas mean weights for the non P-W group have decreased from 221% to 157% IBW. Mean weight losses in the non P-W group = 36.5 kg and are continuing. Lean body mass, studied by H218O, decreased by 5-10% in the first three post operative months but repleted thereafter. In all non P-W cases, plateaus in weight occurred 6-12 months post-operatively, but, in contrast to pre-operative circumstances, patients were able to alter their diets and resume weight loss. Staple line separation occurred by one year in three patients, and required reoperation in one. These results indicate that gastric by-pass surgery may be of considerable benefit to carefully selected obese adolescent patients.
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Dietz, W., Tapper, D. SURGERY FOR ADOLESCENT AND PRADER-WILLI (P-W) OBESITY. Pediatr Res 18 (Suppl 4), 194 (1984). https://doi.org/10.1203/00006450-198404001-00609
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DOI: https://doi.org/10.1203/00006450-198404001-00609