Laparoscopic sleeve gastrectomy in adult and pediatric obese patients: a comparative study
- 610 Downloads
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.
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.
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.
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.
KeywordsBariatric Pediatrics Adult Sleeve gastrectomy Laparoscopic
The authors acknowledge the contribution from Shaikh Ali Alshehri Obesity Chair, and Chair team members Ms. Nesma Mustafa, Ms. Layla Al-Farra, and Mr. Sulthan Najmudeen. They also thank the participants who took part in the study.
Drs. Aayed Alqahtani, Hussam Alamri, Mohamed Elahmedi, and Rafiuddin Mohammed have no conflict of interest or financial ties to disclose.
- 12.Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J (2005) Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA 293(23):2873–2883. Erratum: 294(12):1491Google Scholar
- 18.Alqahtani AR, Antonisamy B, Alamri H, Elahmedi M, Zimmerman VA (2012) Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg. doi: 10.1097/SLA.0b013e318251e92b
- 25.NIH Consensus Conference Statement (1992) Gastrointestinal Surgery for Severe Obesity. National Institutes of Health Consensus Development Conference Statement, March 25-27, 1991. Am J Clin Nutr 55(2):S615–S619Google Scholar
- 26.National Cholesterol Education Program (NCEP) (1992) Highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 89(3):495–501Google Scholar
- 27.Chobanian AV et al (2003) The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report (vol 289, p 2560). JAMA 290(2):197Google Scholar
- 28.National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114(2):555–576Google Scholar
- 31.Anonymous (1983) 1983 metropolitan height and weight tables. Stat Bull Metrop Life Found 64(1):3–9Google Scholar