Introduction: During the last years increasing numbers of children have been reported with a body mass index (BMI) higher than the 85th percentile in the western world. Surgical strategies are still discussed controversially in adolescent patients due to the impact on further maturing process. Laparoscopic adjustable gastric banding (LAGB) is considered as a minimal invasive procedure without alterations on the physiological behavior of the bowel and therefore favored as first choice surgical bariatric treatment in adolescents.
Methods: Between 1998 and 2004 50 adolescent patients above the 99.5th age- and gender-adjusted growing percentile were treated with LAGB. The surgical procedure was performed at three highly experienced centers for Bariatric Surgery. Mean age was 17.1±2.2 years (range 9 to 20 years) at time of surgery. Follow-up investigations were performed in the out-patients clinic of the treating hospitals. Psychological changes were analyzed by the BAROS questionnaire.
Results: The mean BMI decreased from 45.2±7.6kg/m2 at time of surgery to 31.5±10.2kg/m2 after a mean follow up of 56.8±18.8 months (32.6±6.8kg/m2 after 34.7±17.5 months FU, p=0.5). Mean excessive weight loss was 71.8±39.0%. Quality of life improved significantly between 3 to 5 years after operation (BAROS: 5.5±1.9 increased to 6.3±2.2, p=0.01). All preoperative co-morbidities resolved in patients with functioning band.
Conclusion: The determining weight loss results within the first 3 years after surgery and weight remains stable in patients with functioning band thereafter. Perioperative co-morbidities resolve within the first 5 years after treatment. In case of LAGB failure gastric bypass has to be considered even in adolescents.
Session: Podium Presentation
Program Number: S063