Spencer W Trooboff1,2,3, Ryland S Stucke4, Natalie Bv Riblet5, Anupama S Kulkarni5, Rupreet Anand5, Ariana Casey5, Marc A Hofley6. 1. Department of General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. Spencer.W.Trooboff@hitchcock.org. 2. VA Quality Scholars Program, Veterans Health Administration, White River Junction, VT, USA. Spencer.W.Trooboff@hitchcock.org. 3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA. Spencer.W.Trooboff@hitchcock.org. 4. Department of General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. 5. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA. 6. Department of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Abstract
BACKGROUND: Metabolic and bariatric surgery is an effective strategy to curb the natural history of obesity progression and improve psychosocial status in the short term for adolescents with severe obesity. The medium- and long-term psychosocial impact of bariatric surgery in this population is not established. METHODS: We searched MEDLINE (Ovid), EMBASE, Web of Science, PsycInfo, and the Cochrane Libraries through October 2017 for reports of weight loss surgery (roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding) on adolescents with severe obesity (age ≤ 21 years) having ≥ 6 months of follow-up. The primary outcome for inclusion in systematic review was use of a validated quality of life (QoL) or other psychosocial instrument at baseline and postoperatively. We used standardized mean difference (SMD) and random-effects modeling to provide summary estimates across different instruments. RESULTS: We reviewed 5155 studies, of which 20 studies met inclusion criteria for qualitative synthesis. There were 14 studies and 9 unique cohorts encompassing 573 patients which were eligible for meta-analysis regarding postoperative change in QoL. Across surgical procedures, there was significant improvement in QoL of 1.40 SMD (95% confidence interval 0.95 to 1.86; I2 = 89%; p < 0.001) at last follow-up (range 9-94 months). Trends in QoL improvement demonstrated the greatest improvement at 12 months; however, significant improvement was sustained at longest follow-up of 60+ months. CONCLUSIONS: Weight loss surgery is associated with sustained improvement in QoL for adolescents with severe obesity across surgical procedures. Long-term data for psychosocial outcomes reflecting other mental health domains is lacking.
BACKGROUND: Metabolic and bariatric surgery is an effective strategy to curb the natural history of obesity progression and improve psychosocial status in the short term for adolescents with severe obesity. The medium- and long-term psychosocial impact of bariatric surgery in this population is not established. METHODS: We searched MEDLINE (Ovid), EMBASE, Web of Science, PsycInfo, and the Cochrane Libraries through October 2017 for reports of weight loss surgery (roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding) on adolescents with severe obesity (age ≤ 21 years) having ≥ 6 months of follow-up. The primary outcome for inclusion in systematic review was use of a validated quality of life (QoL) or other psychosocial instrument at baseline and postoperatively. We used standardized mean difference (SMD) and random-effects modeling to provide summary estimates across different instruments. RESULTS: We reviewed 5155 studies, of which 20 studies met inclusion criteria for qualitative synthesis. There were 14 studies and 9 unique cohorts encompassing 573 patients which were eligible for meta-analysis regarding postoperative change in QoL. Across surgical procedures, there was significant improvement in QoL of 1.40 SMD (95% confidence interval 0.95 to 1.86; I2 = 89%; p < 0.001) at last follow-up (range 9-94 months). Trends in QoL improvement demonstrated the greatest improvement at 12 months; however, significant improvement was sustained at longest follow-up of 60+ months. CONCLUSIONS:Weight loss surgery is associated with sustained improvement in QoL for adolescents with severe obesity across surgical procedures. Long-term data for psychosocial outcomes reflecting other mental health domains is lacking.
Authors: Ali Aminian; Sangeeta R Kashyap; Kathy E Wolski; Stacy A Brethauer; John P Kirwan; Steven E Nissen; Deepak L Bhatt; Philip R Schauer Journal: Ann Surg Date: 2021-09-01 Impact factor: 13.787
Authors: Piotr Major; Tomasz Stefura; Błażej Dziurowicz; Joanna Radwan; Michał Wysocki; Piotr Małczak; Michał Pędziwiatr Journal: Obes Surg Date: 2020-06-13 Impact factor: 4.129