Julietta H Chang, MD, Elan R Witkowski, MD, MS, Matthew M Hutter, MD, MPH. Massachusetts General Hospital
Introduction: The incidence of obesity in adolescents has more than tripled in the past 40 years. However, data on metabolic and bariatric surgery in adolescents is limited. The Teen-LABS consortium has reported outcomes on 160 patients aged 13-18 operated on from 2007-2012 at 5 institutions, showing that surgery is safe and effective. 70% were gastric bypass and 30% were sleeve gastrectomies. The MBSAQIP has developed an accreditation pathway for adolescent surgery (defined as age<18). The MBSAQIP captures clinically rich data based on standardized bariatric-specific definitions collected at all participating centers, and captures over 95% of all bariatric operations in the US. Data from year 2015 is now available with the Participant Use File (PUF) allowing publication for adolescent results for the first time. Our objective is to describe the current utilization and safety of bariatric surgery in adolescent patients.
Methods: Patients were categorized by age <18 years; 18-21; and >21 years. Patient characteristics, intraoperative data, and 30-day postoperative outcomes were analyzed with univariate analyses and multivariate modeling..jpg?quality=89&ssl=1)
Results: See table. 181 operations were performed in adolescents <18 (0.13% of all operations). There were no patients <13; 39 patients aged 13-16; 58 patients aged 16; and 84 patients aged 17.
In patients <18, 69% underwent sleeve gastrectomy; 24% underwent gastric bypass.
In comparing the adolescent, young adult, and adult age groups, there were no differences in unadjusted rates of death, major complications, or readmissions.
Multivariable logistic regression revealed no independent effect of adolescence on short-term complications.
Conclusions: MBSAQIP data from 181 patients show that bariatric surgery is being performed safely in adolescents. This is the largest real-world, contemporary cohort of adolescent patients analyzed. Adolescent operations remain rare and underutilized. 1 in 13 of adolescents in the US – or about 3.4 million youths – suffer from “extreme obesity” (defined as 120% of the 95th percentile on CDC BMI-for-age growth charts). Only 181 or ~0.005% underwent bariatric surgery in 2015. This is far lower than the ~1% of the 18 million adults estimated to have Class III who undergo bariatric surgery annually. Procedure choice in adolescents mirrors those done in the general population with 69% being sleeve gastrectomies, contrasting with the Teen-LABS cohort from 2007-2012 where 70% of adolescent bariatric procedures were gastric bypasses. Increased awareness of the safety and efficacy of metabolic surgery in adolescents is crucial in order that patients may be offered this life-changing intervention.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88012
Program Number: P587
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster