How safe is adolescent bariatric surgery? An analysis of short-term outcomes

The prevalence of childhood obesity in the U.S. has tripled over the last three decades. However, fewer than 1% of children with severe obesity undergo surgical weight loss interventions each year. All patients age 10 to 19 years old who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) or slee...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric surgery 2022-08, Vol.57 (8), p.1654-1659
Main Authors: Hoeltzel, Gerard D., Swendiman, Robert A., Tewksbury, Colleen M., Parks, Elizabeth Prout, Williams, Noel N., Dumon, Kristoffel R.
Format: Article
Language:English
Subjects:
Abbreviations
Adolescent
ASMBS, American Society for Metabolic and Bariatric Surgery
Bariatric surgery
BMI, Body mass index
CI, Confidence Interval
GERD, Gastroesophageal reflux disease
Obesity
OR, Odds Ratio
RYGB, Roux-en-Y gastric bypass
Safety
SG, Sleeve gastrectomy
Sleeve gastrectomy
SSI, Surgical site infection
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The prevalence of childhood obesity in the U.S. has tripled over the last three decades. However, fewer than 1% of children with severe obesity undergo surgical weight loss interventions each year. All patients age 10 to 19 years old who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2015 through 2018 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database were included in this retrospective cohort analysis. The primary outcomes were mortality and overall complications. Procedural trends, readmission and reoperation rates were also examined using a multivariate regression model. Patients had a mean BMI of 47.3 kg/m2 and 80.0% were either 18 or 19 years old (n = 4,051). There were two reported deaths. Reoperation within 30 days occurred in 1.1% of patients, readmission in 3.5%, and complications in 1.2%. Among all readmissions, primary reasons included nausea/vomiting or nutritional depletion (41.3%) and abdominal pain (16.3%). RYGB was associated with higher odds for readmission (p = 0.006) and complications (p = 0.005). Higher BMI and younger age were not associated with an increased likelihood to experience poorer outcomes. The proportion of patients undergoing SG increased yearly over RYGB from 73.9% in 2015 to 84.3% in 2018. Bariatric surgery appears to be low risk for adolescents and SG has become the operation of choice. More research on early consideration of surgical therapy in adolescents with severe obesity is needed given the safety profile. III
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2021.08.018