A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes
Department of Pediatrics and Surgery, Section of Pediatric Surgery, Rush University Medical Center, Chicago, IL 60612, USA.Journal of Pediatric Surgery (Impact Factor: 1.39). 01/2010; 45(1):74-8; discussion 78-9. DOI: 10.1016/j.jpedsurg.2009.10.013
BACKGROUND AND MATERIALS AND METHODS: The outcome of patients completing 12 months of follow-up in a prospective longitudinal trial of the safety/efficacy of laparoscopic adjustable gastric banding (LAGB) for morbidly obese adolescents aged 14 to 17 years using a Food and Drug Administration Institutional Device Exemption for the use of the LAPBAND was analyzed. Baseline and outcome data were abstracted from a prospective database. RESULTS: Baseline (mean +/- SD) body mass index was 50 +/- 10 kg/m(2), and excess weight was 178 +/- 53 lb in 20 patients. Comorbidities included hypertension (45%), dyslipidemia (80%), insulin resistance (90%), metabolic syndrome (95%), and biopsy-proven nonalcoholic steatohepatitis (88%). At mean (SD) follow-up of 26 (9) months, % excess weight loss was 34% +/- 22% (n = 20) and 41% +/- 27% (n = 12), and the metabolic syndrome was resolved in 63% and 82% of the patients at 12 and 18 months, respectively. Hypertension normalized in all patients, along with improvement in lipid abnormalities and quality of life scores (P < .05). At 12 months, of the 5 patients with less than 20% excess weight loss, dyslipidemia and metabolic syndrome were resolved in 2 patients. CONCLUSION: At intermediate follow-up of a LAGB-based obesity treatment program, weight loss led to resolution or improvement of major obesity-related comorbidities in most patients, supporting the efficacy of LAGB as a surgical adjunct to a comprehensive obesity treatment program and its long-term evaluation.
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ABSTRACT: The assessment of skin/core bond in honeycomb samples was carried out by a bistatic ultrasonic non-contact system. Lamb waves were generated by a Nd:YAG pulsed laser and detected by an air-coupled capacitance transducer located in pitch-catch configuration. Periodically spaced line sources, generated on the sample surface using a four element lenticular array, allowed generation of narrow-band directional Lamb waves. Changes in amplitude of the transmitted signal permitted detection of skin/core disbonds.Ultrasonics Symposium, 2002. Proceedings. 2002 IEEE; 11/2002
- AAP Grand Rounds 07/2010; 24(1):9-9. DOI:10.1542/gr.24-1-9
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ABSTRACT: Children and adolescents who fail to lose weight through diet and exercise programs have been offered weight loss surgery for several years. We report our early results on laparoscopic adjustable gastric banding (LAGB) in 100 teenagers. Candidates for surgery underwent rigorous assessment for medical eligibility, compliance, and psychological well-being. Patients who met criteria and were approved by our team were offered LAGB. Postoperatively, patients were followed monthly until steady weight loss was achieved, then every 3 months thereafter. One hundred patients aged 14 to 19 years underwent LAGB. Preoperative average weight was 136.7 kg, and median body mass index was 48.7. Comorbid medical conditions were common. Five reoperations were performed for port site bleeding, hiatal hernia repair, possible intestinal obstruction, and port slippage. Eighty-seven patients were followed for a minimum of 6 months. Average weight loss at 6 months was 12.4 (range, 33.2 to 16.2) kg, and average change in body mass index was 4.4 (range, 11.8 to -5.6). Laparoscopic adjustable gastric banding may be performed safely in adolescents, and short-term results suggest that LAGB may serve as an important tool to help them lose weight.Journal of Pediatric Surgery 01/2011; 46(1):157-62. DOI:10.1016/j.jpedsurg.2010.09.082 · 1.39 Impact Factor
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