Metabolic and bariatric surgery outcomes in adolescents: a single center's seven-year update.

Autor: Kochis M; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. mkochis@mgh.harvard.edu., Bizimana C; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Stetson A; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Sy M; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Lee H; Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA., Singhal V; Pediatric Endocrinology and Obesity Medicine, UCLA Mattel Children's Hospital, Los Angeles, CA, USA., Gee D; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Pratt JSA; Department of Surgery, Stanford Hospital, Stanford, CA, USA., Griggs CL; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Nov; Vol. 38 (11), pp. 6908-6917. Date of Electronic Publication: 2024 Sep 25.
DOI: 10.1007/s00464-024-11273-0
Abstrakt: Background: Metabolic and bariatric surgery (MBS) is gaining traction as a treatment option for adolescents with severe obesity. Since our weight center last published results in 2014, trends have shown increasingly diverse patient populations undergoing MBS and a shift from laparoscopic Roux-en-Y gastric bypass (LRYGB) to sleeve gastrectomy (LSG). We assessed outcomes including follow-up, weight loss, comorbidity resolution, and complications among our recent adolescent and young adult MBS patients.
Methods: This is a retrospective cohort analysis of patients under 21 years of age with severe obesity who underwent MBS at a single institution between 2014 and 2020. Data on demographics, comorbidities, body mass index (BMI), percent of total body weight loss (%TBWL) at various timepoints, and subsequent complications were collected via chart review. Regression examined associations between preoperative factors, follow-up, and %TBWL.
Results: There were 79 patients of whom 73% were female; overall, 53% were White, 24% Hispanic, and 15% non-Hispanic Black. The majority (80%) of patients underwent LSG. Three-fourths of patients had follow-up data beyond 1 year, and half beyond 3 years. The median %TBWL of LSG patients was 23% at a median follow-up of 3.0 years, and LRYGB patients 28% at 2.4 years. No preoperative factors were associated with follow-up or final %TBWL, but 6-month %TBWL predicted final %TBWL. Preoperatively, 73% of patients had at least one weight-related comorbidity, and 57% had documented improvements in at least one after surgery. There were three 30-day readmissions and no mortalities.
Conclusions: This study, which is an update to a previous series from our center, reflects recent national trends with nearly half non-White patients and predominance of LSG over LRYGB. It adds to a growing body of evidence indicating that MBS is a safe and effective method of achieving weight loss and comorbidity resolution in adolescents with severe obesity.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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