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Obesity Surgery

, Volume 27, Issue 7, pp 1667–1673 | Cite as

Laparoscopic Adjustable Gastric Banding in Australian Adolescents: Should It Be Done?

  • Alexia Sophie PeñaEmail author
  • Tarik DelkoEmail author
  • Richard Couper
  • Kerri Sutton
  • Stamatiki Kritas
  • Taher Omari
  • Jacob Chisholm
  • Lilian Kow
  • Sanjeev Khurana
Original Contributions

Abstract

Objective

There are very few studies on laparoscopic adjustable gastric banding (LAGB) in obese adolescents with follow up for more than 36 months, let alone good prospective data beyond 24 months in Australian adolescents. We aimed to evaluate medium term (>36 months) safety and efficacy of LAGB in adolescents with severe obesity.

Methods

This is a prospective cohort study (March 2009–December 2015) in one tertiary referral hospital including obese adolescents (14–18 years) with a body mass index (BMI) >40 (or ≥35 with comorbidities) who consented to have LAGB. Exclusion criteria were syndromal causes of obesity, depression and oesophageal motility disorders. Main outcome measures include change in weight and BMI at 6, 12, 24, 36 and 48 months post LAGB; postoperative complications; and admissions.

Results

Twenty-one adolescents (median [interquartile range (IQR)] 17.4 [16.5–17.7] years, 9 males, mean ± SD BMI 47.3 ± 8.4 kg/m2) had a median follow up of 45.5 [32–50] months post LAGB. Follow up data were available for 16 adolescents. Weight and BMI improved significantly at all follow up times (all p < 0.01). The median maximum BMI loss was 10 [7.1–14.7] kg/m2. There were four minor early complications. Seven bands were removed due to weight loss failure/regain (two had also obstructive symptoms).

Conclusions

We have shown in the longest prospective LAGB postoperative follow up study of Australian adolescents that LAGB improves BMI in the majority of adolescents without significant comorbidities. LAGB is still a reasonable option to be considered as a temporary procedure to manage severe obesity during adolescence.

Keywords

Adolescents Obese Bariatric surgery Lap band Longitudinal study 

Notes

Acknowledgement

We thank Dr. Tracy Glass (PhD, Biostatistics and Epidemiology) for her statistical analysis review.

Compliance with Ethical Standards

Disclosure

There are no potential benefits in any form from a commercial party related directly or indirectly to the subject of this manuscript.

Conflict of Interest

The authors declare that they have no conflict of interest.

Grant Information

This study was funded by Women’s and Children’s Hospital Foundation Research Project Grant.

Ethical Statement

Study was conducted in accordance to the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent Statement

Informed consent and assent was obtained from all parents of participants and all individual participants included in the study.

References

  1. 1.
    Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    O’Dea JA, Dibley MJ. Prevalence of obesity, overweight and thinness in Australian children and adolescents by socioeconomic status and ethnic/cultural group in 2006 and 2012. Int J Public Health. 2014;59:819–28.CrossRefPubMedGoogle Scholar
  3. 3.
    Sanders RH, Han A, Baker JS, et al. Childhood obesity and its physical and psychological co-morbidities: a systematic review of Australian children and adolescents. Eur J Pediatr. 2015;174:715–46.CrossRefPubMedGoogle Scholar
  4. 4.
    Goran MI, Ball GDC, Cruz ML. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab. 2003;88:1417–27.CrossRefPubMedGoogle Scholar
  5. 5.
    Oude Luttikhuis H, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane database Syst Rev 2009;CD001872Google Scholar
  6. 6.
    Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. National Health and Medical Research Council 2013 (https://www.nhmrc.gov.au/guidelines-publications/n57)
  7. 7.
    McDonagh MS, Selph S, Ozpinar A, et al. Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger. JAMA Pediatr. 2014;168:178–84.CrossRefPubMedGoogle Scholar
  8. 8.
    Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.CrossRefPubMedGoogle Scholar
  9. 9.
    Zitsman JL, DiGiorgi MF, Fennoy I, et al. Adolescent laparoscopic adjustable gastric banding (LAGB): prospective results in 137 patients followed for 3 years. Surg Obes Relat Dis. 2015;11:101–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Ells LJ, Mead E, Atkinson G, et al. Surgery for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev. 2015;6:CD011740.Google Scholar
  11. 11.
    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;168:47–53.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Paulus GF, de Vaan LEG, Verdam FJ, et al. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015;25:860–78.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    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.CrossRefPubMedGoogle Scholar
  14. 14.
    Yitzhak A, Mizrahi S, Avinoach E. Laparoscopic gastric banding in adolescents. Obes Surg. 2006;16:1318–22.CrossRefPubMedGoogle Scholar
  15. 15.
    Baur LA, Fitzgerald DA. Recommendations for bariatric surgery in adolescents in Australia and New Zealand. J Paediatr Child Health. 2010;46:704–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Silberhumer GR, Miller K, Pump A, et al. Long-term results after laparoscopic adjustable gastric banding in adolescent patients: follow-up of the Austrian experience. Surg Endosc. 2011;25:2993–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Dolan K, Creighton L, Hopkins G, et al. Laparoscopic gastric banding in morbidly obese adolescents. Obes Surg. 2003;13:101–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Fielding GA, Duncombe JE. Laparoscopic adjustable gastric banding in severely obese adolescents. Surg Obes Relat Dis. 2005;1:399–405; discussion 405-7. Google Scholar
  19. 19.
    Dindo D, Demartines N, Clavien P-A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Carlin AM, Zeni TM, English WJ, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg. 2013;257:791–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Naef M, Mouton WG, Naef U, et al. Graft survival and complications after laparoscopic gastric banding for morbid obesity—lessons learned from a 12-year experience. Obes Surg. 2010;20:1206–14.CrossRefPubMedGoogle Scholar
  22. 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.CrossRefPubMedGoogle Scholar
  23. 23.
    Moon RC, Teixeira AF, DuCoin C, et al. Comparison of cholecystectomy cases after Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric banding. Surg Obes Relat Dis. 2013;10:64–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Shoar S, Nguyen T, Ona MA, et al. Roux-en-Y gastric bypass reversal: a systematic review. Surg Obes Relat Dis. 2016;12:1366–72.CrossRefPubMedGoogle Scholar
  25. 25.
    Thurnheer M, Bisang P, Ernst B, et al. A novel distal very long Roux-en y gastric bypass (DVLRYGB) as a primary bariatric procedurecomplication rates, weight loss, and nutritional/metabolic changes in the first 355 patients. Obes Surg. 2012;22:1427–36.CrossRefPubMedGoogle Scholar
  26. 26.
    Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRefPubMedGoogle Scholar
  27. 27.
    Altieri MS, Yang J, Telem DA, et al. Lap band outcomes from 19, 221 patients across centers and over a decade within the state of New York. Surg Endosc. 2016;30:1725–32.CrossRefPubMedGoogle Scholar
  28. 28.
    Angrisani L, Cutolo PP, Formisano G, et al. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis. 9:405–13.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Alexia Sophie Peña
    • 1
    • 2
    Email author
  • Tarik Delko
    • 3
    Email author
  • Richard Couper
    • 4
  • Kerri Sutton
    • 3
  • Stamatiki Kritas
    • 4
  • Taher Omari
    • 4
    • 5
  • Jacob Chisholm
    • 3
  • Lilian Kow
    • 3
  • Sanjeev Khurana
    • 1
    • 6
  1. 1.Robinson Research Institute and Discipline of PaediatricsThe University of AdelaideAdelaideAustralia
  2. 2.Endocrinology and Diabetes DepartmentWomen’s and Children’s Hospital (WCH)North AdelaideAustralia
  3. 3.Department of Gastrointestinal SurgeryFlinders Medical CentreAdelaideAustralia
  4. 4.Gastroenterology DepartmentWomen’s and Children’s Hospital (WCH)North AdelaideAustralia
  5. 5.Human Physiology, Medical Science and Technology, School of MedicineFlinders UniversityAdelaideAustralia
  6. 6.Paediatric SurgeryWomen’s and Children’s Hospital (WCH)North AdelaideAustralia

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