Advertisement

Obesity Surgery

, Volume 28, Issue 7, pp 2040–2045 | Cite as

Five-year Outcomes of Laparoscopic Sleeve Gastrectomy: a Comparison Between Adults and Adolescents

  • Nesreen KhidirEmail author
  • Moamena Ahmed El-Matbouly
  • Davit Sargsyan
  • Mohammed Al-Kuwari
  • Moataz Bashah
  • Michel Gagner
Original Contributions

Abstract

Background

Bariatric surgery in adolescents is still under debate. Literature about the long-term impact of laparoscopic sleeve gastrectomy (LSG) on adolescents’ obesity and associated morbidities is scarce. It is unknown if LSG shows better long-term results in the adolescent or adult group.

Aim

To compare the long-term effectiveness of LSG on obesity and associated comorbidities between adolescents and adults.

Methods

This retrospective study analyzed all patients with morbid obesity who underwent LSG in (2011–2012) and were followed for up to 5 years. Patients were divided into two groups: adolescents and adults. Data were compared between the two groups.

Results

LSG was performed in 139 adults and 91 adolescents. The mean ages of the adults and adolescents were 37.4 ± 11.4 and 17 ± 1.5 years, respectively. The preoperative body mass index values of the adults and adolescents were 48.4 ± 8.7 and 47.6 ± 7.5 kg/m2, respectively (P = 0.95). At 5 years, percentage of total weight loss increased in adolescents (to 35.8 ± 11.5%), while it remained almost the same in adults (26.3 ± 10%). At 1 year, about 68.2% of adults and 62.5% of adolescents were cured from diabetes though, 13% of diabetic adults had relapse at 5 years and none of the adolescents relapsed. Postoperative complications occurred in both groups.

Conclusion

LSG showed comparable weight loss results in adults and adolescents, with better results in adolescents. LSG is more effective in preventing and treating diabetes/prediabetes in the adolescent group.

Keywords

Adolescents Diabetes Pre-diabetes Laparoscopic sleeve gastrectomy 

Notes

Acknowledgments

We thank our colleague Mr. Arnel Alviz (system analyst, Hamad Medical Corporation-Qatar) who offered great help with the data collection and statistical analysis. We would also like to show our gratitude to Professor Michel Gagner, as he operated on most of the study population. We acknowledge doctors Helmuth Billy (Director of Bariatric and Metabolic Surgery St Johns Regional Medical Center, Oxnard, California US), Peter Goh (Professor of Surgery at Monash University, Sunway Campus), and Alan Saber (Clinical professor of Surgery-Icahn School Of Medicine at Mount Sinai, US) for their contribution as visiting operating surgeons of some cases.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The current study was conducted after the research protocol was approved by the institutional review board of the Medical Research Centre at Hamad Medical Corporation. For this type of study, formal consent is not required.

References

  1. 1.
    Bener A. Prevalence of obesity, overweight, and underweight in Qatari adolescents. Food Nutr Bull. 2006;27(1):39–45.  https://doi.org/10.1177/156482650602700106.CrossRefPubMedGoogle Scholar
  2. 2.
    Gatimu SM, Milimo BW, San Sebastian M. Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health. 2016;16(1):1174.  https://doi.org/10.1186/s12889-016-3845-8.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Juonala M, Magnussen CG, Berenson GS, et al. Childhood adiposity, adult adiposity and cardiovascular risk factors. N Engl J Med. 2011;365(20):1876–85.  https://doi.org/10.1056/NEJMoa1010112.CrossRefPubMedGoogle Scholar
  4. 4.
    Alqahtani AR, Elahmedi MO, Al Qahtani A. Co-morbidity resolution in morbidly obese children and adolescents undergoing sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(5):842–50.  https://doi.org/10.1016/j.soard.2014.01.020.CrossRefPubMedGoogle Scholar
  5. 5.
    Al-Sabah S, Almazeedi S, Dashti S, et al. The efficacy of laparoscopic sleeve gastrectomy in treating adolescent obesity. Obes Surg. 2015;25(1):50–4.  https://doi.org/10.1007/s11695-014-1340-9.CrossRefPubMedGoogle Scholar
  6. 6.
    Benedix F, Krause T, Adolf D, et al. Perioperative course, weight loss and resolution of comorbidities after primary sleeve gastrectomy for morbid obesity: are there differences between adolescents and adults? Obes Surg. 2017;27:1–10.Google Scholar
  7. 7.
    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. 2017;  https://doi.org/10.1007/s11695-017-2884-2.
  8. 8.
    Elhag W, El Ansari W, Abdulrazzaq S, et al. Evolution of 29 anthropometric, nutritional, and cardiometabolic parameters among morbidly obese adolescents 2 years post sleeve gastrectomy. Obes Surg. 2017;  https://doi.org/10.1007/s11695-017-2868-2.
  9. 9.
    Disease of obesity. ASMBS-2017 available at (https://asmbs.org/patients/disease-of-obesity).
  10. 10.
    Tomei S, Mamtani R, Al Ali R, et al. Obesity susceptibility loci in Qataris, a highly consanguineous Arabian population. J Transl Med. 2015;13(1):119.  https://doi.org/10.1186/s12967-015-0459-3.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hofmann B. Bariatric surgery for obese children and adolescents: a review of the moral challenges. BMC Med Ethics. 2013;4:18.  https://doi.org/10.1186/1472-6939-14-18.CrossRefGoogle Scholar
  12. 12.
    Beamish AJ, Reinehr T. Should bariatric surgery be performed in adolescents? Eur J Endocrinol. 2017;176(4):D1–5.  https://doi.org/10.1530/EJE-16-0906.CrossRefPubMedGoogle Scholar
  13. 13.
    Childerhose JE, Alsamawi A, Mehta T, et al. Review article Adolescent bariatric surgery: a systematic review of recommendation documents. Surg Obes Relat Dis. 2017;13(10):1768–79.  https://doi.org/10.1016/j.soard.2017.08.008.CrossRefPubMedGoogle Scholar
  14. 14.
    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(2):113–23.  https://doi.org/10.1056/NEJMoa1506699.CrossRefPubMedGoogle Scholar
  15. 15.
    American Diabetes Association. Promoting health and reducing disparities in populations. Sec. 1. In Standards of Medical Care in Diabetesd 2017. Diabetes Care 2017; 40. http://professional.diabetes.org/sites/professional.diabetes.org/files/media/dc.
  16. 16.
    Cambuli VM, Incani M, Pilia S, et al. Oral glucose tolerance test in Italian overweight/obese children and adolescents results in a very high prevalence of impaired fasting glycaemia, but not of diabetes. Diabetes Metab Res Rev. 2009;25(6):528–34.  https://doi.org/10.1002/dmrr.980.CrossRefPubMedGoogle Scholar
  17. 17.
    Reinehr T, Wabitsch M, Kleber M, et al. Parental diabetes, pubertal stage, and extreme obesity are the main risk factors for prediabetes in children and adolescents: a simple risk score to identify children at risk for prediabetes. Pediatr Diabetes. 2009;10(6):395–400.  https://doi.org/10.1111/j.1399-5448.2008.00492.x.CrossRefPubMedGoogle Scholar
  18. 18.
  19. 19.
    Tsamis D, Plastiras A, Natoudi M. Impact of laparoscopic sleeve gastrectomy on weight loss and associated comorbidities in adolescents and young adults. J Laparoendosc Adv Surg Tech A. 2015;25(12):971–5.  https://doi.org/10.1089/lap.2015.0426.CrossRefPubMedGoogle Scholar
  20. 20.
    Pedroso FE, Gander J, Oh PS, et al. Laparoscopic vertical sleeve gastrectomy significantly improves short term weight loss as compared to laparoscopic adjustable gastric band placement in morbidly obese adolescent patients. J Pediatr Surg. 2015;50:115–22.CrossRefPubMedGoogle Scholar
  21. 21.
    Kashyap SR, Gatmaitan P, Brethauer S, et al. Bariatric surgery for type 2 diabetes: weighing the impact for obese patients. Cleve Clin J Med. 2010;77:468–76.  https://doi.org/10.3949/ccjm.77a.09135.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nesreen Khidir
    • 1
    Email author
  • Moamena Ahmed El-Matbouly
    • 2
  • Davit Sargsyan
    • 1
  • Mohammed Al-Kuwari
    • 1
  • Moataz Bashah
    • 1
    • 3
  • Michel Gagner
    • 4
  1. 1.Department of Bariatric and Metabolic SurgeryHamad Medical CorporationDohaQatar
  2. 2.Department of General SurgeryHamad Medical CorporationDohaQatar
  3. 3.Weill Cornell Medical collegeDohaQatar
  4. 4.Department of SurgeryHopital du Sacre CoeurMontrealCanada

Personalised recommendations