Abstract
Objective:
To examine the safety and effectiveness of adolescent bariatric surgery and to improve treatment recommendations for this age group.
Design:
Prospective longitudinal registry. Since January 2005, patients undergoing bariatric surgery in Germany are enlisted in an online registry called ‘study for quality assurance in obesity surgeries’.
Subjects:
Adolescents and young adults up to the age of 21 years, operated from January 2005 to December 2010.
Measurements:
Weight, BMI, comorbidities, complication rates.
Results:
N=345 primary procedures were recorded by 58 hospitals. N=51 patients were under the age of 18 years. Follow-up information was available for 48% (n=167) of patients, with an average observation period of 544±412 days (median: 388 days). The most common surgical techniques were gastric banding (n=118, 34.2%), gastric bypass (n=116, 33.6%) and sleeve gastrectomy (n=78, 22.6%). Short-term complications (intra-operative; general postoperative; specific postoperative) were slightly lower for gastric banding (0.8%; 2.5%; 0.8%) than for gastric bypass (2.6%; 5.2%; 1.7%) or sleeve gastrectomy (0%; 9.0%; 7.7%). In accordance with published findings, weight and BMI reduction were lower for gastric banding (−28 kg; −9.5 kg m−2) compared to gastric bypass (−50 kg; −16.4 kg m−2) P< 0.001 or sleeve gastrectomy (−46 kg; -15.4 kg m−2) P< 0.001. Outcomes did not differ between the <18 and ⩾18-year-old patients.
Conclusion:
Like in adults, bariatric surgery has low short-term complication rates and results in sustained weight loss in adolescents. However, the missing long-term observations prohibit a final conclusion about lasting effectiveness and safety. Clinical trials with structured follow-up programs and mechanisms to ascertain patient adherences are needed.
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Acknowledgements
This project was funded by the Federal Ministry of Education and Research (BMBF 01GI1120A and 01GI1124) and is integrated in the Competence Network Obesity.
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Lennerz, B., Wabitsch, M., Lippert, H. et al. Bariatric surgery in adolescents and young adults—safety and effectiveness in a cohort of 345 patients. Int J Obes 38, 334–340 (2014). https://doi.org/10.1038/ijo.2013.182
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DOI: https://doi.org/10.1038/ijo.2013.182
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