Article

Surgical Endoscopy

, Volume 26, Issue 11, pp 3094-3100

First online:

Laparoscopic sleeve gastrectomy in adult and pediatric obese patients: a comparative study

  • Aayed AlqahtaniAffiliated withDepartment of Surgery, College of Medicine, King Saud University, Obesity Chair Email author 
  • , Hussam AlamriAffiliated withDepartment of Surgery, College of Medicine, King Saud University
  • , Mohamed ElahmediAffiliated withDepartment of Surgery, College of Medicine, King Saud University
  • , Rafiuddin MohammedAffiliated withDepartment of Surgery, College of Medicine, King Saud University

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is a recent bariatric procedure that has gained widespread popularity in morbidly obese adults. However, pediatric bariatric surgery is controversial, and the type(s) of bariatric surgery that are suitable for children and adolescents is under debate. No studies exit that compare LSG outcomes in adult and pediatric patients. We reviewed our experience to assess the safety, efficacy, and complications of LSG in adult and pediatric morbidly obese patients.

Methods

A retrospective review of all patients who underwent LSG by a single surgeon between March 2008 and February 2011 was performed. The 222 patients included 108 pediatric patients aged 21 years or younger and 114 adult patients older than 21 years. Baseline, operative, perioperative, and available follow-up data were abstracted.

Results

Pediatric patients had a mean age of 13.9 ± 4.3 years and a mean baseline body mass index (BMI) of 49.6 kg/m2, whereas adults had a mean age of 32.2 ± 9.4 years and a mean baseline BMI of 48.3 kg/m2. Our pediatric group achieved a mean percent of excess weight loss (%EWL) of 32.4, 52.1, 65.8, and 64.9 % at 3, 6, 12, and 24 months postoperative, respectively, compared with a mean %EWL of 30.9, 55.2, 68.5, and 69.7 %, respectively, in our adult group (p > 0.05). During the 24-month follow-up period, pediatric patients attended 71.7 % of follow-up visits, whereas adults attended 61.2 % of follow-up visits (p = 0.01). Postoperative complications occurred in six (5.6 %) and eight (7 %) pediatric and adult patients, respectively.

Conclusions

Laparoscopic sleeve gastrectomy in the pediatric age group is of similar safety and effectiveness compared with adults. Pediatric patients had fewer major complications and were more compliant with follow-up than adults. Nevertheless, long-term results are required to further clarify the safety and effectiveness of LSG in pediatric patients.

Keywords

Bariatric Pediatrics Adult Sleeve gastrectomy Laparoscopic