Skip to main content
SpringerLink
Log in

Laparoscopic Sleeve Gastrectomy for Adolescents Under 18 Years Old with Severe Obesity

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Introduction

Laparoscopic sleeve gastrectomy (LSG) is a widely accepted stand-alone bariatric operation. Data on adolescent patients undergoing LSG are limited. The aim of this study was to demonstrate that LSG is safe and effective for patients strictly under 18 years old with severe obesity.

Methods

Prospectively collected data from consecutive patients undergoing LSG were retrospectively analyzed. Patients with more than 1-year follow-up were included in the analysis for weight loss and comorbidity evaluation. Quality of life (QoL) was evaluated using the Short-Form 36 questionnaire.

Results

Eighty-four patients under 18 years old (range: 15–17 years) underwent LSG. Median weight was 128 kg and median body mass index (BMI) 43.7 kg/m2. Median duration of surgery was 68.5 min. One major complication was recorded: a patient developed severe pneumonia that necessitated ventilatory support in intensive care unit and intravenous antibiotic treatment. Mortality was null. Median length of hospital stay was 4 days. Six, 12, and 24 months after LSG, median BMI decreased significantly to 34.3, 29.8, and 28.8 kg/m2, respectively (p < 0.001), with a mean percentage of total body weight loss of 29.1% at 2 years. Obesity-related comorbidities improved at 1 year, while all SF-36 scale scores of QoL assessment improved significantly.

Conclusion

This study suggests that LSG is safe and effective for patients under 18 years old, resulting in significant weight loss, comorbidity remission, and QoL improvement. Careful patient selection after adequate risk versus benefit evaluation by an expert multidisciplinary team is essential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. 2014;370:403–11.

    Article  CAS  Google Scholar 

  2. Baker JL, Olsen LW, Sorensen TI. Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med. 2007;357:2329–37.

    Article  CAS  Google Scholar 

  3. Must A, Jacques PF, Dallal GE, et al. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard growth study of 1922 to 1935. N Engl J Med. 1992;327:1350–5.

    Article  CAS  Google Scholar 

  4. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003;289:1813–9.

    Article  Google Scholar 

  5. Matson KL, Fallon RM. Treatment of obesity in children and adolescents. J Pediatr Pharmacol Ther. 2012;17:45–57.

    PubMed  PubMed Central  Google Scholar 

  6. Danielsson P, Kowalski J, Ekblom O, et al. Response of severely obese children and adolescents to behavioral treatment. Arch Pediatr Adolesc Med. 2012;166:1103–8.

    Article  Google Scholar 

  7. Kalarchian MA, Levine MD, Arslanian SA, et al. Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics. 2009;124:1060–8.

    Article  Google Scholar 

  8. Deitel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), new York City, October 25-27, 2007. Obes Surg. 2008;18:487–96.

    Article  Google Scholar 

  9. O'Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257:87–94.

    Article  Google Scholar 

  10. Treadwell JR, Sun F, Schoelles K. Systematic review and meta-analysis of bariatric surgery for pediatric obesity. Ann Surg. 2008;248:763–76.

    Article  Google Scholar 

  11. Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14:492–7.

    Article  Google Scholar 

  12. Weller WE, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.

    Article  Google Scholar 

  13. Risstad H, Sovik TT, Engstrom M, et al. Five-year outcomes after laparoscopic gastric bypass and laparoscopic duodenal switch in patients with body mass index of 50 to 60: a randomized clinical trial. JAMA Surg. 2015;150:352–61.

    Article  Google Scholar 

  14. van Rutte PW, Smulders JF, de Zoete JP, et al. Outcome of sleeve gastrectomy as a primary bariatric procedure. Br J Surg. 2014;101:661–8.

    Article  Google Scholar 

  15. Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.

    Article  Google Scholar 

  16. Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.

    Article  Google Scholar 

  17. Deitel M, Gagner M, Erickson AL, et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749–59.

    Article  Google Scholar 

  18. Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256:262–5.

    Article  Google Scholar 

  19. O'Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303:519–26.

    Article  CAS  Google Scholar 

  20. Nadler EP, Reddy S, Isenalumhe A, et al. Laparoscopic adjustable gastric banding for morbidly obese adolescents affects android fat loss, resolution of comorbidities, and improved metabolic status. J Am Coll Surg. 2009;209:638–44.

    Article  Google Scholar 

  21. de la Cruz-Munoz N, Messiah SE, Cabrera JC, et al. Four-year weight outcomes of laparoscopic gastric bypass surgery and adjustable gastric banding among multiethnic adolescents. Surg Obes Relat Dis. 2010;6:542–7.

    Article  Google Scholar 

  22. Inge TH, Courcoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374:113–23.

    Article  CAS  Google Scholar 

  23. Boza C, Viscido G, Salinas J, et al. Laparoscopic sleeve gastrectomy in obese adolescents: results in 51 patients. Surg Obes Relat Dis. 2012;8:133–7. discussion 7-9

    Article  Google Scholar 

  24. Till H, Bluher S, Hirsch W, et al. Efficacy of laparoscopic sleeve gastrectomy (LSG) as a stand-alone technique for children with morbid obesity. Obes Surg. 2008;18:1047–9.

    Article  CAS  Google Scholar 

  25. Nocca D, Nedelcu M, Nedelcu A, et al. Laparoscopic sleeve gastrectomy for late adolescent population. Obes Surg. 2014;24:861–5.

    Article  Google Scholar 

  26. Alqahtani AR, Antonisamy B, Alamri H, et al. Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg. 2012;256:266–73.

    Article  Google Scholar 

  27. Ejaz A, Patel P, Gonzalez-Heredia R, et al. Laparoscopic sleeve gastrectomy as first-line surgical treatment for morbid obesity among adolescents. J Pediatr Surg. 2017;52:544–8.

    Article  Google Scholar 

  28. Inge TH, Coley RY, Bazzano LA, et al. Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study. Surg Obes Relat Dis. 2018;14:1374–86.

    Article  Google Scholar 

  29. El-Matbouly MA, Khidir N, Touny HA, et al. A 5-year follow-up study of laparoscopic sleeve gastrectomy among morbidly obese adolescents: does it improve body image and prevent and treat diabetes? Obes Surg. 2018;28:513–9.

    Article  Google Scholar 

  30. Haute Autorité de Santé (2016) Définition des critères de réalisation des interventions de chirurgie bariatrique chez les moins de 18 ans. https://www.has-sante.fr/portail/jcms/c_2010309/fr/definition-des-criteres-de-realisation-des-interventions-de-chirurgie-bariatrique-chez-les-moins-de-18-ans. Accessed 30 Mar 2016.

  31. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  Google Scholar 

  32. Gaillard M, Tranchart H, Lainas P, et al. Single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients. Surg Obes Relat Dis. 2016;12:1270–7.

    Article  Google Scholar 

  33. Leplege A, Ecosse E, Verdier A, et al. The French SF-36 health survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol. 1998;51:1013–23.

    Article  CAS  Google Scholar 

  34. Ruiz-Cota P, Bacardi-Gascon M, Jimenez-Cruz A. Long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: a systematic review. Surg Obes Relat Dis. 2019;15:133–44.

    Article  Google Scholar 

  35. Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257:231–7.

    Article  Google Scholar 

  36. Khen-Dunlop N, Dabbas M, De Filippo G, et al. Primordial influence of post-operative compliance on weight loss after adolescent laparoscopic adjustable gastric banding. Obes Surg. 2016;26:98–104.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, 92140, Clamart, France

    Panagiotis Lainas, Rabih Mikhael & Ibrahim Dagher

  2. Paris-Saclay University, 91405, Orsay, France

    Panagiotis Lainas & Ibrahim Dagher

  3. Department of Adolescent Medicine, Bicetre Hospital, Assistance Publique - Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France

    Gianpaolo De Filippo & Pierre Bougneres

  4. French Clinical Research Group in Adolescent Medicine and Health, Paris, France

    Gianpaolo De Filippo

  5. Department of Digestive Surgery, Orsay Hospital, 91400, Orsay, France

    Giuseppe Di Giuro

Authors
  1. Panagiotis Lainas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gianpaolo De Filippo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Di Giuro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rabih Mikhael
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierre Bougneres
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ibrahim Dagher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Panagiotis Lainas.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lainas, P., De Filippo, G., Di Giuro, G. et al. Laparoscopic Sleeve Gastrectomy for Adolescents Under 18 Years Old with Severe Obesity. OBES SURG 30, 267–273 (2020). https://doi.org/10.1007/s11695-019-04150-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-019-04150-6

Keywords

Search

Navigation