Orit Blumenfeld1, Nahum Beglaibter2, Nissim Geron3, Rita Dichtiar4, David Hazzan5,6, Lital Keinan-Boker4,7, David Goitein5,6. 1. Israel Center for Disease Control, Ministry of Health, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel. Orit.blumenfeld@moh.health.gov.il. 2. Department of Surgery, Hadassah Har Hazofim Medical Center, Jerusalem, Israel. 3. Department of Surgery, Poria Medical Center, Tiberius, Israel. 4. Israel Center for Disease Control, Ministry of Health, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel. 5. Department of Surgery C, Chaim Sheba Medical Center, Ramat Gan, Israel. 6. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 7. School of Public Health, University of Haifa, Haifa, Israel.
Abstract
OBJECTIVE: Most published work on bariatric surgery (BS) in adolescents describes outcomes after laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass. We compared the efficacy of LAGB and laparoscopic sleeve gastrectomy (LSG) in adolescents. METHODS: A National Bariatric Registry was queried for adolescents who underwent BS between June 2013 and December 2015. We collected data on weight and height at baseline and 1-year following surgery, subsequent hospitalizations, interventions, and mortality, which were compared at 30 days post-surgery and until last follow-up (maximum 4.2 years post-surgery). Mortality and hospitalization data were extracted from national databases. RESULTS: Two hundred fifty-nine adolescents (60% females) aged 12-19 years were included. Mean age and body mass index (BMI) were 17.5 ± 1.2 years and 45.1 ± 5.0 kg/m2, respectively. LSG (n = 227, 87.6%) and LAGB (n = 32, 12.4%) were the most common procedures performed. LSG group achieved greater average at 1 year BMI loss compared to LAGB group (15.4 ± 4.7 kg/m2 vs. 10.3 ± 5.1 kg/m2 respectively; p = 0.0001) and higher rate with BMI < 30 kg/m2 1 year post-surgery (57.7% (n = 131) vs. 25% (n = 8), respectively; p = 0.0005). Males who underwent LSG reduced BMI more than their female counterparts (p = 0.0001), LSG was the strongest independent predictor for BMI < 30 after 1 year (OR = 4.1; 95% CI 1.7-9.9) followed by age (OR = 1.3; 95% CI1.0-1.6). No mortality was observed. Postoperative hospitalizations between the two groups did not differ (hazard ratio 2.4; 95% CI 0.7-7.9; p = 0.1). CONCLUSION: Compared to LAGB, LSG is superior regarding weight loss with a similar risk of short- and long-term hospitalizations, complications, and interventional procedures. Males lose more weight following LSG.
OBJECTIVE: Most published work on bariatric surgery (BS) in adolescents describes outcomes after laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass. We compared the efficacy of LAGB and laparoscopic sleeve gastrectomy (LSG) in adolescents. METHODS: A National Bariatric Registry was queried for adolescents who underwent BS between June 2013 and December 2015. We collected data on weight and height at baseline and 1-year following surgery, subsequent hospitalizations, interventions, and mortality, which were compared at 30 days post-surgery and until last follow-up (maximum 4.2 years post-surgery). Mortality and hospitalization data were extracted from national databases. RESULTS: Two hundred fifty-nine adolescents (60% females) aged 12-19 years were included. Mean age and body mass index (BMI) were 17.5 ± 1.2 years and 45.1 ± 5.0 kg/m2, respectively. LSG (n = 227, 87.6%) and LAGB (n = 32, 12.4%) were the most common procedures performed. LSG group achieved greater average at 1 year BMI loss compared to LAGB group (15.4 ± 4.7 kg/m2 vs. 10.3 ± 5.1 kg/m2 respectively; p = 0.0001) and higher rate with BMI < 30 kg/m2 1 year post-surgery (57.7% (n = 131) vs. 25% (n = 8), respectively; p = 0.0005). Males who underwent LSG reduced BMI more than their female counterparts (p = 0.0001), LSG was the strongest independent predictor for BMI < 30 after 1 year (OR = 4.1; 95% CI 1.7-9.9) followed by age (OR = 1.3; 95% CI1.0-1.6). No mortality was observed. Postoperative hospitalizations between the two groups did not differ (hazard ratio 2.4; 95% CI 0.7-7.9; p = 0.1). CONCLUSION: Compared to LAGB, LSG is superior regarding weight loss with a similar risk of short- and long-term hospitalizations, complications, and interventional procedures. Males lose more weight following LSG.
Entities:
Keywords:
Adolescents; Bariatric surgery; Complications; Follow-up; Registry; Survival; Weight loss
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