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Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding.
J Pediatr Surg. 2007 Jan; 42(1):137-41; discussion 141-2.JP

Abstract

BACKGROUND

Obesity in the adolescent population has reached epidemic proportions. Although diet and behavior modification can help a minority of teenagers, most of these patients go on to become obese adults. Recently, surgical intervention for morbid obesity has gained increasing support. To date, this has only included gastric bypass procedures. However, this procedure carries at least a 1% mortality rate even in the hands of the most experienced surgeons. Therefore, our center has been using laparoscopic adjustable gastric banding (LAGB) to treat adolescents with morbid obesity. This analysis is a report of our short-term results in our first 53 patients.

METHODS

All adolescents aged 13 to 17 years who had undergone LAGB at our institution and had been entered into our prospectively collected database since 2001 were reviewed. Data collected preoperatively included age, sex, race, and body mass index (BMI). Postoperatively recorded data included length of stay, operative morbidity, need for reoperation, as well as percentage of excess weight loss (%EWL) and BMI at 3-month intervals.

RESULTS

Fifty-three teenagers aged 13 to 17 years (mean, 15.9 years) underwent LAGB at our institution since September 2001. Of these, 41 were female and 12 were male. The mean preoperative weight was 297 +/- 53 lb and the mean initial BMI was 47.6 +/- 6.7 kg/m2. The %EWL was 37.5 +/- 17.0 at 6 months, 62.7 +/- 27.6 at 1 year, and 48.5 +/- 15.6 at 18 months of follow-up. There were no intraoperative complications. Two patients had band slips that required laparoscopic repositioning, and 2 patients developed a symptomatic hiatal hernia that required laparoscopic repair. All of these procedures were performed as outpatient procedures. A fifth patient developed a wound infection requiring incision and drainage. Other complications included mild hair loss in 5 patients, iron deficiency in 4 patients, nephrolithiasis and cholelithiasis in 1 patient, and gastroesophageal reflux in 1 patient.

CONCLUSIONS

Laparoscopic adjustable gastric banding is not only a safe operation for morbidly obese pediatric patients, but also represents an effective treatment strategy with a %EWL of approximately 50% at both 1 year and 18 months of follow-up. Because of the minimal morbidity and complete absence of mortality of the LAGB, it is the optimal surgical option for pediatric patients with morbid obesity.

Authors+Show Affiliations

Division of Pediatric Surgery, New York University School of Medicine, New York, NY 10016, USA. evan.nadler@med.nyu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17208554

Citation

Nadler, Evan P., et al. "Short-term Results in 53 US Obese Pediatric Patients Treated With Laparoscopic Adjustable Gastric Banding." Journal of Pediatric Surgery, vol. 42, no. 1, 2007, pp. 137-41; discussion 141-2.
Nadler EP, Youn HA, Ginsburg HB, et al. Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding. J Pediatr Surg. 2007;42(1):137-41; discussion 141-2.
Nadler, E. P., Youn, H. A., Ginsburg, H. B., Ren, C. J., & Fielding, G. A. (2007). Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding. Journal of Pediatric Surgery, 42(1), 137-41; discussion 141-2.
Nadler EP, et al. Short-term Results in 53 US Obese Pediatric Patients Treated With Laparoscopic Adjustable Gastric Banding. J Pediatr Surg. 2007;42(1):137-41; discussion 141-2. PubMed PMID: 17208554.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding. AU - Nadler,Evan P, AU - Youn,Heekoung A, AU - Ginsburg,Howard B, AU - Ren,Christine J, AU - Fielding,George A, PY - 2007/1/9/pubmed PY - 2007/2/6/medline PY - 2007/1/9/entrez SP - 137-41; discussion 141-2 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 42 IS - 1 N2 - BACKGROUND: Obesity in the adolescent population has reached epidemic proportions. Although diet and behavior modification can help a minority of teenagers, most of these patients go on to become obese adults. Recently, surgical intervention for morbid obesity has gained increasing support. To date, this has only included gastric bypass procedures. However, this procedure carries at least a 1% mortality rate even in the hands of the most experienced surgeons. Therefore, our center has been using laparoscopic adjustable gastric banding (LAGB) to treat adolescents with morbid obesity. This analysis is a report of our short-term results in our first 53 patients. METHODS: All adolescents aged 13 to 17 years who had undergone LAGB at our institution and had been entered into our prospectively collected database since 2001 were reviewed. Data collected preoperatively included age, sex, race, and body mass index (BMI). Postoperatively recorded data included length of stay, operative morbidity, need for reoperation, as well as percentage of excess weight loss (%EWL) and BMI at 3-month intervals. RESULTS: Fifty-three teenagers aged 13 to 17 years (mean, 15.9 years) underwent LAGB at our institution since September 2001. Of these, 41 were female and 12 were male. The mean preoperative weight was 297 +/- 53 lb and the mean initial BMI was 47.6 +/- 6.7 kg/m2. The %EWL was 37.5 +/- 17.0 at 6 months, 62.7 +/- 27.6 at 1 year, and 48.5 +/- 15.6 at 18 months of follow-up. There were no intraoperative complications. Two patients had band slips that required laparoscopic repositioning, and 2 patients developed a symptomatic hiatal hernia that required laparoscopic repair. All of these procedures were performed as outpatient procedures. A fifth patient developed a wound infection requiring incision and drainage. Other complications included mild hair loss in 5 patients, iron deficiency in 4 patients, nephrolithiasis and cholelithiasis in 1 patient, and gastroesophageal reflux in 1 patient. CONCLUSIONS: Laparoscopic adjustable gastric banding is not only a safe operation for morbidly obese pediatric patients, but also represents an effective treatment strategy with a %EWL of approximately 50% at both 1 year and 18 months of follow-up. Because of the minimal morbidity and complete absence of mortality of the LAGB, it is the optimal surgical option for pediatric patients with morbid obesity. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/17208554/Short_term_results_in_53_US_obese_pediatric_patients_treated_with_laparoscopic_adjustable_gastric_banding_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(06)00666-X DB - PRIME DP - Unbound Medicine ER -