Challenges in Transition of Care for Pediatric Patients after Weight-Reduction Surgery: a Systematic Review and Recommendations for Comprehensive Care
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Obesity in pediatric patients is rising with nearly one third of children in the USA classified as overweight and up to 16–18% of the adolescent population obese with at least one comorbid condition. Consequently, bariatric procedures in this population have increased without consistent recommendations for follow-up and transition to adult providers. This review describes the known and potential long-term consequences of bariatric surgery in pediatric patients, reviews the current literature on transitions of care for adolescent patients with chronic illnesses. Additionally, this review summarizes recommendations from the literature for developing a standardized program for transitioning care for post-bariatric surgical patients and offers useful tools and guidelines for doing so.
KeywordsPediatric obesity Bariatric surgery Outcomes Transitions in care
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The authors have no relevant financial or other disclosures to report.
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None of the authors have any disclaimers or conflicts of interests to report nor were any funds, proprietary or otherwise, used to fund this research.
None of the authors have any disclaimers, conflicts of interest, or use of previously copyrighted material to report. No grant support or financial relationships were employed in the conduct of this research.
This work has not been submitted for presentation.
- 4.Childhood obesity facts. 2017; https://www.cdc.gov/healthyschools/obesity/facts.htm, 2017.
- 15.Weiss AL, Taguchi M, Aslam S, et al. Adolescent bariatric surgery: identifying comorbidities and evaluating success of an interdisciplinary treatment team. J Adolesc Health. 2016;58((2)Google Scholar
- 21.Reinehr T, Bucksch J, Müller A, et al. 7-Year follow-up of a lifestyle intervention in overweight children: comparison to an untreated control group. Clin Nutr. 2017;Google Scholar
- 24.Inge TH, Zeller MH, Jenkins TM, et al. Perioperative outcomes of adolescents undergoing bariatric surgery: the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. JAMA Pediatr. 2014;168(1):47–53. https://doi.org/10.1001/jamapediatrics.2013.4296.CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Estimate of bariatric surgery numbers, 2011–2015. 2016; https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers, 2017.
- 28.Vinzens F, Kilchenmann A, Zumstein V, et al. Long-term outcome of laparoscopic adjustable gastric banding (LAGB): results of a Swiss single-center study of 405 patients with up to 18 years' follow-up. Surg Obes Relat Dis. 2017;13(8):1313–9. https://doi.org/10.1016/j.soard.2017.04.030.CrossRefPubMedGoogle Scholar
- 35.Shoar S, Mahmoudzadeh H, Naderan M, et al. Long-term outcome of bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis of 950 patients with a minimum of 3 years follow-up. Obes Surg. 2017;Google Scholar
- 36.Kristensen SD, Jess P, Floyd AK, et al. Internal herniation after laparoscopic antecolic Roux-en-Y gastric bypass: a nationwide Danish study based on the Danish National Patient Register. Surg Obes Relat Dis. 2016;12(2):297–303. https://doi.org/10.1016/j.soard.2015.10.059.CrossRefPubMedGoogle Scholar
- 41.Kanerva N, Larsson I, Peltonen M, et al. Changes in total energy intake and macronutrient composition after bariatric surgery predict long-term weight outcome: findings from the Swedish Obese Subjects (SOS) study. Am J Clin Nutr. 2017;106(1):136–45. https://doi.org/10.3945/ajcn.116.149112.CrossRefPubMedGoogle Scholar
- 43.Dogan K, Homan J, Aarts EO, et al. Long-term nutritional status in patients following Roux-en-Y gastric bypass surgery. Clin Nutr. 2017; https://doi.org/10.1016/j.clnu.2017.01.022.
- 46.Ziegler O, Sirveaux MA, Brunaud L, et al. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009;35(6 Pt 2):544–57. https://doi.org/10.1016/S1262-3636(09)73464-0.CrossRefPubMedGoogle Scholar
- 50.American College of Surgeons: National Surgical Quality Improvement Program Pediatric. In:2016.Google Scholar
- 53.Pediatrics AAo, Physicians AAoF, Medicine ACoP-ASoI. A consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110(6 Pt 2):1304–6.Google Scholar
- 56.Chu PY, Maslow GR, von Isenburg M, et al. Systematic review of the impact of transition interventions for adolescents with chronic illness on transfer from pediatric to adult healthcare. J Pediatr Nurs. 2015;30(5):e19–27. https://doi.org/10.1016/j.pedn.2015.05.022.CrossRefPubMedPubMedCentralGoogle Scholar
- 59.Peters A, Laffel L, Group ADATW. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems: a position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, the Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society). Diabetes Care. 2011;34(11):2477–85.CrossRefPubMedPubMedCentralGoogle Scholar
- 66.Brill JV, Ashmore JA, Brengman ML, et al. White Paper AGA: an episode-of-care framework for the management of obesity-moving toward high value, high quality care: a report from the American Gastroenterological Association Institute Obesity Episode of Care and Bundle Initiative Work Group. Clin Gastroenterol Hepatol. 2017;15(5):650–664.e652.Google Scholar
- 67.Kelsall AC, Cassidy R, Ghaferi AA. Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector. Ann Surg. 2017:1. https://doi.org/10.1097/SLA.0000000000002462.
- 71.Got transition center for health care transition improvement. 2017; http://www.gottransition.org, 2017.