Laparoscopic Gastric Bypass in Adolescents: a Prospective Analysis of Dynamic of Weight Loss.

Piotr Gorecki, MD, Alok Aggarwal, MD, Elizabeth Lax, MD, Anthony Tortolani, MD, Wojciech Gorecki, MD. Department of Surgery, New York Methodist Hospital, Brooklyn, NY

 

Introduction: With an epidemic of obesity among American children and adolescents, and growing popularity of bariatric surgery in adults, little data focusing on dynamics of weight loss and potential outcome differences in these groups of bariatric patients is available.

Objective: The purpose of this study is to evaluate the dynamic of weight loss in adolescent patients (AP) undergoing laparoscopic Roux-Y gastric bypass (LRYGB) and compare the results with the older patient (OP) population undergoing the same procedure.

Materials and Methods: We present our experience with 41 adolescent (18 to 21 years of age) patients who underwent LRYGB at our institution between August 2001 and August of 2011. All patients met the NIH criteria for bariatric surgery and were operated by a single surgeon (PG). All patients were evaluated preoperatively in the multidisciplinary setting that included pediatrician. The data were collected prospectively. The weight loss patterns for both groups were measured at the following intervals: excess weight loss at one week, 1, 3, 6, 9, and 12 months, and 2, 3, 4 and 5 years. In addition, age groups were compared in regard to distribution of weight loss (percent of excess BMI loss at 1 -year – EBMI) in 5 distribution groups. Group I included patients with EBMI loss of < 25%, group II – between 26 and 50 EBMI%, group III- 51% -75% of EBMI loss, group IV – 75%-100% EBMI loss and group V >100 % EBMI loss.

Results: Out of 652 patients who underwent LRYGB, 41 were between ages of 18 and 21 (6.72%, mean age 19.75). There were 31 females (76%) and 10 males (24%) with an average body mass index (BMI) of 49.86 kg/m2 (range 41-64). All operations were completed laparoscopicaly with no intraoperative complications. Mean length of hospital stay was similar for the two groups (2.89 days for AP vs. 3,1 days for OP, p=0.585). There was one (3.2%) major postoperative complication an 3 minor complications in the AP group. There were no long-term disabilities and no mortalities in either group. At 1-year follow up, the EBMI loss was 72.67% for AP and 75.36% for OP group and was similar (p=0.51). In addition, at one year follow up, the distribution of weight loss in both patient population was as follow: Group I contained 4.2% AP vs. 0% OP patients, group II -12.5% vs. 9.6%, group II 37.5% vs. 43.6%, group IV 33.3% vs. 38.0% and Group V 12.5% vs. 8.8%. There was no significant differences in weight loss patterns in the two groups (p=0.798). Comparable weight loss pattern extended up to 5 years after surgery with 5-year follow up BMI 32.67 for AP and 30.38 for OP (P=0.492).

Conclusion: The dynamic distribution of the pattern of weight loss up to 5 year after LRYGB was similar in both groups. The results of bariatric surgery in adolescent patients appear to parallel those in adult population.


Session Number: Poster – Poster Presentations
Program Number: P498
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