Oscar K Serrano1,2, Yang Zhang3, Emily Kintzer3, Erin Moran-Atkin4,3, Jenny Choi4,3, W Scott Melvin4,3, Diego R Camacho4,3. 1. Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA. o.k.serrano@gmail.com. 2. Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA. o.k.serrano@gmail.com. 3. Department of Surgery, Albert Einstein College of Medicine, New York, NY, USA. 4. Montefiore Institute for Minimally Invasive Surgery, Montefiore Medical Center, 3400 Bainbridge Avenue, MAP 4, Bronx, NY, 104647, USA.
Abstract
BACKGROUND: Medical weight loss options are rarely successful long term in young patients. Bariatric surgery has been shown to be safe and effective in this population. METHODS: Patients ≤21 years old who had bariatric surgery at our institution between January 2009 and December 2013 were evaluated to determine the safety and efficacy of bariatric surgery in this population. The primary end point was excess weight loss (EWL). Secondary end points included surgical morbidity, improvement in obesity-related metabolic parameters, and subjective obesity-related symptoms at 1 year. RESULTS: Fifty-four patients were identified who had a laparoscopic Roux-en-Y gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG). Fourteen patients were male (25.9 %), and 40 patients were female (74.1 %). Thirty-seven patients (68.5 %) underwent LGBP, and 17 patients (31.5 %) underwent LSG. Median follow-up was 13.3 months. The baseline BMI was 51.7 kg/m2 for the LGBP group and 51.0 kg/m2 for the LSG group. EWL was 35.2, 47.6, 62.4, 58.1, and 61.8 % for the LGBP group; 29.7, 44.7, 57.4, 60.3, and 59.0 % for the LSG group at 3, 6, 12, 24, and 36 months, respectively. Our complications included 1 anastomotic bleed, 1 postoperative stricture, and 1 patient who developed vitamin deficiency that manifested as a peripheral neuropathy in the LGBP group. LGBP was more successful than LSG in improving lipid panel parameters and HbA1c at 1 year, and it also seemed to offer better subjective improvement in obesity-related symptoms. CONCLUSIONS: LGBP and LSG seem to confer comparable weight loss benefit in patients ≤21 years old with acceptable surgical morbidity.
BACKGROUND: Medical weight loss options are rarely successful long term in young patients. Bariatric surgery has been shown to be safe and effective in this population. METHODS:Patients ≤21 years old who had bariatric surgery at our institution between January 2009 and December 2013 were evaluated to determine the safety and efficacy of bariatric surgery in this population. The primary end point was excess weight loss (EWL). Secondary end points included surgical morbidity, improvement in obesity-related metabolic parameters, and subjective obesity-related symptoms at 1 year. RESULTS: Fifty-four patients were identified who had a laparoscopic Roux-en-Y gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG). Fourteen patients were male (25.9 %), and 40 patients were female (74.1 %). Thirty-seven patients (68.5 %) underwent LGBP, and 17 patients (31.5 %) underwent LSG. Median follow-up was 13.3 months. The baseline BMI was 51.7 kg/m2 for the LGBP group and 51.0 kg/m2 for the LSG group. EWL was 35.2, 47.6, 62.4, 58.1, and 61.8 % for the LGBP group; 29.7, 44.7, 57.4, 60.3, and 59.0 % for the LSG group at 3, 6, 12, 24, and 36 months, respectively. Our complications included 1 anastomotic bleed, 1 postoperative stricture, and 1 patient who developed vitamin deficiency that manifested as a peripheral neuropathy in the LGBP group. LGBP was more successful than LSG in improving lipid panel parameters and HbA1c at 1 year, and it also seemed to offer better subjective improvement in obesity-related symptoms. CONCLUSIONS:LGBP and LSG seem to confer comparable weight loss benefit in patients ≤21 years old with acceptable surgical morbidity.
Authors: C Lubrano; S Mariani; M Badiali; M Cuzzolaro; G Barbaro; S Migliaccio; G Genovesi; F Rossi; M Celanetti; D Fiore; M M Pandolfo; P Specchia; G Spera Journal: Int J Obes (Lond) Date: 2010-04-20 Impact factor: 5.095
Authors: Deirdre C Kelleher; Chaya T Merrill; Linda T Cottrell; Evan P Nadler; Randall S Burd Journal: JAMA Pediatr Date: 2013-02 Impact factor: 16.193
Authors: Oscar K Serrano; Jonathan E Tannebaum; Lindsay Cumella; Jenny Choi; Pratibha Vemulapalli; W Scott Melvin; Diego R Camacho Journal: Surg Endosc Date: 2015-08-25 Impact factor: 4.584
Authors: Kirsten Bibbins-Domingo; Pamela Coxson; Mark J Pletcher; James Lightwood; Lee Goldman Journal: N Engl J Med Date: 2007-12-06 Impact factor: 91.245
Authors: Omar Nunez Lopez; Daniel C Jupiter; Fredrick J Bohanon; Ravi S Radhakrishnan; Kanika A Bowen-Jallow Journal: J Adolesc Health Date: 2017-09-01 Impact factor: 5.012
Authors: Janey S A Pratt; Allen Browne; Nancy T Browne; Matias Bruzoni; Megan Cohen; Ashish Desai; Thomas Inge; Bradley C Linden; Samer G Mattar; Marc Michalsky; David Podkameni; Kirk W Reichard; Fatima Cody Stanford; Meg H Zeller; Jeffrey Zitsman Journal: Surg Obes Relat Dis Date: 2018-03-23 Impact factor: 4.734
Authors: Lauren A Sarno; Steven E Lipshultz; Carroll Harmon; Nestor F De La Cruz-Munoz; Preetha L Balakrishnan Journal: Pediatr Res Date: 2019-08-11 Impact factor: 3.756
Authors: A S Shah; T Jenkins; Z Gao; S R Daniels; E M Urbina; S Kirk; R Siegel; T H Inge Journal: Int J Obes (Lond) Date: 2017-06-09 Impact factor: 5.095