Lennerz B.S.,University of Ulm |
Wabitsch M.,University of Ulm |
Lippert H.,Otto Von Guericke University of Magdeburg |
Lippert H.,Institute for Quality Assurance in Surgical Medicine at the University Hospital |
And 5 more authors.
International Journal of Obesity | Year: 2014
Objective:To examine the safety and effectiveness of adolescent bariatric surgery and to improve treatment recommendations for this age group.Design:Prospective longitudinal registry. Since January 2005, patients undergoing bariatric surgery in Germany are enlisted in an online registry called 'study for quality assurance in obesity surgeries'.Subjects:Adolescents and young adults up to the age of 21 years, operated from January 2005 to December 2010.Measurements:Weight, BMI, comorbidities, complication rates.Results:N=345 primary procedures were recorded by 58 hospitals. N=51 patients were under the age of 18 years. Follow-up information was available for 48% (n=167) of patients, with an average observation period of 544±412 days (median: 388 days). The most common surgical techniques were gastric banding (n=118, 34.2%), gastric bypass (n=116, 33.6%) and sleeve gastrectomy (n=78, 22.6%). Short-term complications (intra-operative; general postoperative; specific postoperative) were slightly lower for gastric banding (0.8%; 2.5%; 0.8%) than for gastric bypass (2.6%; 5.2%; 1.7%) or sleeve gastrectomy (0%; 9.0%; 7.7%). In accordance with published findings, weight and BMI reduction were lower for gastric banding (-28 kg; -9.5 kg m -2) compared to gastric bypass (-50 kg; -16.4 kg m -2) P< 0.001 or sleeve gastrectomy (-46 kg; -15.4 kg m -2) P< 0.001. Outcomes did not differ between the <18 and ≥18-year-old patients.Conclusion:Like in adults, bariatric surgery has low short-term complication rates and results in sustained weight loss in adolescents. However, the missing long-term observations prohibit a final conclusion about lasting effectiveness and safety. Clinical trials with structured follow-up programs and mechanisms to ascertain patient adherences are needed. © 2014 Macmillan Publishers Limited.