Angelo Iossa1, Francesco De Peppo2, Romina Caccamo2, Brad Michael Watkins3, Francesca Abbatini1, Emanuela Ceriati2, Gianfranco Silecchia4. 1. Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, "La Sapienza", University of Rome, Rome, Italy. 2. Department of Paediatric Surgery, Hospital Bambino Gesù", Palidoro (Rm), Italy. 3. Division of General Surgery and Weight LOSS Center, West Chester Hospital, University of Cincinnati, Cincinnati, OH, USA. 4. Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence, "La Sapienza", University of Rome, Rome, Italy. gianfranco.silecchia@uniroma1.it.
Abstract
INTRODUCTION: Childhood obesity is an emerging health problem. Surgical treatment of obese adolescents, particularly those affected by congenital syndrome, represents a controversial issue. The aim of this multicenter study was to retrospectively assess the results of laparoscopic sleeve gastrectomy (LSG) in a cohort of adolescents affected by morbid obesity, with or without congenital syndromes. MATERIALS AND METHODS: Forty-one obese (BMI 49 ± 6 kg/m2) adolescents with mean age of 16 ± 3 years (58.5% with previous intragastric balloon failure), and subjected to LSG, were retrospectively evaluated for complications rate, % excess weight loss (%EWL), and inhibition of co-morbidities after 2 years of follow-up. RESULTS: All the operations were completed laparoscopically and no intra-operative complications were recorded. No mortality was recorded while peri- or post-operative complications only occurred in two patients (4.9%). The EWL% at 6, 12, and 24 months were 42.3, 58.3, and 59.4, respectively. %EWL was comparable (p = 0.7) between non-syndromic and syndromic obese adolescents at 24 months. Conversely patients with previous intragastric balloon surgery had a significant lower EWL (%) at 24 month (p < 0.01). Moreover, at the same time point, co-morbidity resolution rate was 78.2% while improvement rate was 57.6%. Specifically, remission rate of type 2 diabetes (T2DM), hypertension and obstructive sleep apnea (OSA) were 71, 75 and 61%, respectively. CONCLUSION: LSG is advantageous in the treatment of morbidly obese juveniles concerning safety, weight loss and co-morbidity control and at same time presenting, a possible effective therapeutic option for patients affected by congenital syndrome.
INTRODUCTION: Childhood obesity is an emerging health problem. Surgical treatment of obese adolescents, particularly those affected by congenital syndrome, represents a controversial issue. The aim of this multicenter study was to retrospectively assess the results of laparoscopic sleeve gastrectomy (LSG) in a cohort of adolescents affected by morbid obesity, with or without congenital syndromes. MATERIALS AND METHODS: Forty-one obese (BMI 49 ± 6 kg/m2) adolescents with mean age of 16 ± 3 years (58.5% with previous intragastric balloon failure), and subjected to LSG, were retrospectively evaluated for complications rate, % excess weight loss (%EWL), and inhibition of co-morbidities after 2 years of follow-up. RESULTS: All the operations were completed laparoscopically and no intra-operative complications were recorded. No mortality was recorded while peri- or post-operative complications only occurred in two patients (4.9%). The EWL% at 6, 12, and 24 months were 42.3, 58.3, and 59.4, respectively. %EWL was comparable (p = 0.7) between non-syndromic and syndromic obese adolescents at 24 months. Conversely patients with previous intragastric balloon surgery had a significant lower EWL (%) at 24 month (p < 0.01). Moreover, at the same time point, co-morbidity resolution rate was 78.2% while improvement rate was 57.6%. Specifically, remission rate of type 2 diabetes (T2DM), hypertension and obstructive sleep apnea (OSA) were 71, 75 and 61%, respectively. CONCLUSION: LSG is advantageous in the treatment of morbidly obese juveniles concerning safety, weight loss and co-morbidity control and at same time presenting, a possible effective therapeutic option for patients affected by congenital syndrome.
Entities:
Keywords:
Adolescents; Bariatric surgery in teenagers; Childhood obesity; Sleeve gastrectomy; Surgical treatment; Syndromic obesity
Authors: David Nocca; Marius Nedelcu; Anamaria Nedelcu; Patrick Noel; Phillipe Leger; Mehdi Skalli; Patrick Lefebvre; Yannael Coisel; Caroline Laurent; Frederic Lemaitre; Jean Michel Fabre Journal: Obes Surg Date: 2014-06 Impact factor: 4.129
Authors: Marc P Michalsky; Thomas H Inge; Mark Simmons; Todd M Jenkins; Ralph Buncher; Michael Helmrath; Mary L Brandt; Carroll M Harmon; Anita Courcoulas; Michael Chen; Mary Horlick; Stephen R Daniels; Elaine M Urbina Journal: JAMA Pediatr Date: 2015-05 Impact factor: 16.193
Authors: Meg H Zeller; Thomas H Inge; Avani C Modi; Todd M Jenkins; Marc P Michalsky; Michael Helmrath; Anita Courcoulas; Carroll M Harmon; Dana Rofey; Amy Baughcum; Heather Austin; Karin Price; Stavra A Xanthakos; Mary L Brandt; Mary Horlick; Ralph Buncher Journal: J Pediatr Date: 2014-12-30 Impact factor: 4.406
Authors: Jill L Kaar; Nazeen Morelli; Samuel P Russell; Ishaah Talker; Jaime M Moore; Thomas H Inge; Kristen J Nadeau; Stephen M M Hawkins; Mark S Aloia; Stacey L Simon Journal: Surg Obes Relat Dis Date: 2020-12-17 Impact factor: 4.734