Zubaidah Nor Hanipah, MD1, Suriya Punchai, MD1, Gautam Sharma, MD2, Emre Bucak, MD1, Ali Aminian, MD1, Stacy Brethauer, MD1, Philip Schauer, MD1. 1Bariatric and Metabolic Institute, Cleveland Clinic, 2Section of Surgical Endoscopy, Dept. of General Surgery, Cleveland Clinic
Introduction: The prevalence of obesity among adolescents is rapidly increasing and is associated with substantial co-morbid disease states. At present, bariatric procedures in carefully selected patients are recommended in order to have a better quality of life and resolution of the co-morbidities. The aim of this study is to review our experience with adolescents who underwent bariatric surgery.
Methods: Patients aged 19 years and younger who underwent bariatric surgery at a single academic center between 2006 and 2015 were identified. Data collected included baseline demographics, co-morbidities, perioperative parameters, 30-day and 1-year complications and the weight loss and co-morbidities resolution. Data was summarized as the mean and standard deviation for continuous variables and as counts and frequency for categorical variables.
Results: A total of 37 patients aged 19 years and below was identified. Twenty seven (73%) were female, mean age was 17.9±1.1 years, preoperative mean body weight 143.9±28.5kg and mean body mass index (BMI) was 51.2±9.2kg/m2. Comorbidities include sleep apnea (n=17, 46%), fatty liver (n=11, 30%), hypertension (n=9, 24%), dyslipidemia (n=5, 14 %), and diabetes mellitus (n=3, 8%).
All the bariatric procedures were primary procedures and performed laparoscopically: Roux-en-Y gastric bypass (n=23, 62%), sleeve gastrectomy (n= 12, 32%) and adjustable gastric banding (n=2, 5%). The mean operative time was 118.9±44.9 minutes and the mean length of stay was 3±3 days. There were 2 patients (5.4%) with 30-day post-operative complications: pneumonia (n=1) and heart failure in preexisting congenital heart disease (n=1). At 8-month follow, one patient had the conversion of sleeve gastrectomy to duodenal switch as a second-stage procedure. There was no unplanned readmission, re-operation, morbidity or mortality in this cohort.
The mean %excess weight loss at 1-year (follow-up of 54%), 2-years (follow-up of 35%) and 5-years (follow-up of 22%) were 68 ±26%, 64±24%, and 65 ±32% respectively. In the mean follow-up time of 23±22 months, remission of diabetes, improvement of hypertension and dyslipidemia occurred in 2 out of 2, 4 out of 4 and 2 out of 2 patients with available data, respectively.
Conclusion: Our experience suggests that bariatric surgery in selected adolescents is safe and effective in managing obesity-related comorbidities. Age alone should not be the limiting factor for selecting patients for bariatric surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80032
Program Number: P543
Presentation Session: Poster (Non CME)
Presentation Type: Poster