Jeffrey L Zitsman1,2, Mary F DiGiorgi3, Adina Z Zhang4, Janet Schauben Kopchinski5,6, Robyn Sysko7, Michael J Devlin8,9, Ilene Fennoy5,10. 1. Division of Pediatric Surgery, Morgan Stanley Children's Hospital of New York Presbyterian/Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA. jlz2@cumc.columbia.edu. 2. Department of Surgery, Vagellos College of Physicians and Surgeons of Columbia University, 3959, Broadway, NY, 10032, USA. jlz2@cumc.columbia.edu. 3. Department of Surgery, Vagellos College of Physicians and Surgeons of Columbia University, 3959, Broadway, NY, 10032, USA. 4. Mailman School of Public Health, Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA. 5. Department of Pediatrics, Vagellos College of Physicians and Surgeons of Columbia University, 3959, Broadway, NY, 10032, USA. 6. Division of Pediatric GI/Nutrition, Morgan Stanley Children's Hospital of New York Presbyterian/Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA. 7. Eating and Weight Disorders Program, Icahn School of Medicine at Mt. Sinai, 3959, Broadway, NY, 10032, USA. 8. Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, 3959, Broadway, NY, 10032, USA. 9. Department of Psychiatry, Vagellos College of Physicians and Surgeons, Columbia University, 3959, Broadway, NY, 10032, USA. 10. Division of Pediatric Endocrinology, Morgan Stanley Children's Hospital of New York Presbyterian/Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA.
Abstract
BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is used to treat obesity in adults. Less is known about long-term results of the procedure in adolescents. OBJECTIVES: To evaluate LAGB 5-year outcomes in teenagers with severe obesity. SETTING: Children's hospital, USA. METHODS: Adolescents (14-18 years) underwent LAGB in an FDA-approved observational clinical trial. Outcomes including anthropometric measurements, comorbid conditions, complications, and band retention were collected through 60 months. RESULTS: One hundred thirty-seven subjects underwent LAGB (94 female, 43 male; 43% white, 37% Hispanic, 17% black; 4% other). Mean age and body mass index (BMI) pre-operatively were 17.0 + 1.2 years and 48.3 + 8.2 kg/m2, respectively. Comorbidities were present in 71%. Maximum weight loss occurred by 36 months (mean % excess weight loss (EWL) 40.6 + 35.2, mean % excess BMI loss (EBMIL) 41.6 + 34.9) and was maintained through 5 years for most subjects. There were no significant differences in weight loss by gender. Twenty-three (18%) of 127 adolescents reporting at 60 months achieved 50% excess weight loss. Postoperative heartburn and emesis occurred in 70% and 32%, respectively. Complications requiring additional surgery occurred 80 times in 63 patients. Thirty-three (26%) of 127 subjects contacted at 5 years had undergone band removal. CONCLUSION: In this study, fewer than 20% of adolescents with severe obesity lost > 50% of their excess weight following LAGB. Nearly 50% of patients required additional surgery. With reports of success following sleeve gastrectomy and gastric bypass, we believe that LAGB is not a preferred choice to treat adolescents with obesity.
BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is used to treat obesity in adults. Less is known about long-term results of the procedure in adolescents. OBJECTIVES: To evaluate LAGB 5-year outcomes in teenagers with severe obesity. SETTING:Children's hospital, USA. METHODS: Adolescents (14-18 years) underwent LAGB in an FDA-approved observational clinical trial. Outcomes including anthropometric measurements, comorbid conditions, complications, and band retention were collected through 60 months. RESULTS: One hundred thirty-seven subjects underwent LAGB (94 female, 43 male; 43% white, 37% Hispanic, 17% black; 4% other). Mean age and body mass index (BMI) pre-operatively were 17.0 + 1.2 years and 48.3 + 8.2 kg/m2, respectively. Comorbidities were present in 71%. Maximum weight loss occurred by 36 months (mean % excess weight loss (EWL) 40.6 + 35.2, mean % excess BMI loss (EBMIL) 41.6 + 34.9) and was maintained through 5 years for most subjects. There were no significant differences in weight loss by gender. Twenty-three (18%) of 127 adolescents reporting at 60 months achieved 50% excess weight loss. Postoperative heartburn and emesis occurred in 70% and 32%, respectively. Complications requiring additional surgery occurred 80 times in 63 patients. Thirty-three (26%) of 127 subjects contacted at 5 years had undergone band removal. CONCLUSION: In this study, fewer than 20% of adolescents with severe obesity lost > 50% of their excess weight following LAGB. Nearly 50% of patients required additional surgery. With reports of success following sleeve gastrectomy and gastric bypass, we believe that LAGB is not a preferred choice to treat adolescents with obesity.
Entities:
Keywords:
Adjustable gastric banding; Adolescent weight loss surgery
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