TY - JOUR
T1 - Perioperative outcomes of adolescents undergoing bariatric surgery
T2 - The teen-longitudinal assessment of bariatric surgery (Teen-LABS) study
AU - Inge, Thomas H.
AU - Zeller, Meg H.
AU - Jenkins, Todd M.
AU - Helmrath, Michael
AU - Brandt, Mary L.
AU - Michalsky, Marc P.
AU - Harmon, Carroll M.
AU - Courcoulas, Anita
AU - Horlick, Mary
AU - Xanthakos, Stavra A.
AU - Dolan, Larry
AU - Mitsnefes, Mark
AU - Barnett, Sean J.
AU - Buncher, Ralph
PY - 2014/1
Y1 - 2014/1
N2 - Importance: Severe obesity in childhood is a major health problem with few effective treatments. Weight-loss surgery (WLS) is being used to treat severely obese adolescents, although with very limited data regarding surgical safety for currently used, minimally invasive procedures. Objective: To assess the preoperative clinical characteristics and perioperative safety outcomes of severely obese adolescents undergoing WLS. Design, setting, and participants: This prospective, multisite observational study enrolled patients from February 28, 2007, through December 30, 2011. Consecutive patients aged 19 years or younger who were approved to undergo WLS (n = 277) were offered enrollment into the study at 5 academic referral centers in the United States; 13 declined participation and 22 did not undergo surgery after enrollment, thus the final analysis cohort consisted of 242 individuals. There were no withdrawals. Main outcomes and measures: This analysis examined preoperative anthropometrics, comorbid conditions, and major and minor complications occurring within 30 days of operation. All data were collected in a standardized fashion. Reoperations and hospital readmissions were adjudicated by independent reviewers to assess relatedness to the WLS procedure. Results: The mean (SD) age of participants was 17.1 (1.6) years and the median body mass index (calculated as weight in kilograms divided by height in meters squared) was 50.5. Fifty-one percent demonstrated 4 or more major comorbid conditions. Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6%of patients, respectively. There were no deaths during the initial hospitalization or within 30 days of operation; major complications (eg, reoperation) were seen in 19 patients (8%). Minor complications (eg, readmission for dehydration) were noted in 36 patients (15%). All reoperations and 85% of readmissions were related to WLS. Conclusions and relevance: In this series, adolescents with severe obesity presented with abundant comorbid conditions. We observed a favorable short-term complication profile, supporting the early postoperative safety of WLS in select adolescents. Further longitudinal study of this cohort will permit accurate assessment of long-term outcomes for adolescents undergoing bariatric surgery.
AB - Importance: Severe obesity in childhood is a major health problem with few effective treatments. Weight-loss surgery (WLS) is being used to treat severely obese adolescents, although with very limited data regarding surgical safety for currently used, minimally invasive procedures. Objective: To assess the preoperative clinical characteristics and perioperative safety outcomes of severely obese adolescents undergoing WLS. Design, setting, and participants: This prospective, multisite observational study enrolled patients from February 28, 2007, through December 30, 2011. Consecutive patients aged 19 years or younger who were approved to undergo WLS (n = 277) were offered enrollment into the study at 5 academic referral centers in the United States; 13 declined participation and 22 did not undergo surgery after enrollment, thus the final analysis cohort consisted of 242 individuals. There were no withdrawals. Main outcomes and measures: This analysis examined preoperative anthropometrics, comorbid conditions, and major and minor complications occurring within 30 days of operation. All data were collected in a standardized fashion. Reoperations and hospital readmissions were adjudicated by independent reviewers to assess relatedness to the WLS procedure. Results: The mean (SD) age of participants was 17.1 (1.6) years and the median body mass index (calculated as weight in kilograms divided by height in meters squared) was 50.5. Fifty-one percent demonstrated 4 or more major comorbid conditions. Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6%of patients, respectively. There were no deaths during the initial hospitalization or within 30 days of operation; major complications (eg, reoperation) were seen in 19 patients (8%). Minor complications (eg, readmission for dehydration) were noted in 36 patients (15%). All reoperations and 85% of readmissions were related to WLS. Conclusions and relevance: In this series, adolescents with severe obesity presented with abundant comorbid conditions. We observed a favorable short-term complication profile, supporting the early postoperative safety of WLS in select adolescents. Further longitudinal study of this cohort will permit accurate assessment of long-term outcomes for adolescents undergoing bariatric surgery.
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U2 - 10.1001/jamapediatrics.2013.4296
DO - 10.1001/jamapediatrics.2013.4296
M3 - Article
C2 - 24189578
AN - SCOPUS:84892687680
SN - 2168-6203
VL - 168
SP - 47
EP - 53
JO - A.M.A. American journal of diseases of children
JF - A.M.A. American journal of diseases of children
IS - 1
ER -