Laparoscopic adjustable gastric banding in adolescent: safety and efficacy

Division of Pediatric Surgery, King Khalid University Hospital, Riyadh 11671, Saudi Arabia.
Journal of Pediatric Surgery (Impact Factor: 1.39). 06/2007; 42(5):894-7. DOI: 10.1016/j.jpedsurg.2006.12.057
Source: PubMed


Obesity prevalence is rapidly increasing among children and adolescents worldwide. It is considered one of the most alarming public health issues facing the world today. The adult experience has demonstrated that surgery is the only effective means of achieving persistent weight loss in obese patients. However, little is known about bariatric surgery in children and adolescents. The aim of this study is to evaluate the safety and efficacy of laparoscopic adjustable gastric banding (LAGB) in this group of patients.
A retrospective review included all children and adolescents who underwent LAGB from January 2003 to December 2005.
Fifty-one patients underwent LAGB. The mean age was 16.8 years (range, 9-19), and the mean body mass index was 49.9 kg/m2 (range, 38-63). Mean excess weight loss was 42% at 6 months and 60% at 1 year follow-up. The most prevalent comorbidities were obstructive sleep apnea, limited physical activities, hypertension, and diabetes mellitus. Band adjustments were performed under fluoroscopic guidance in 5 patients and direct access as a clinic procedure in the remaining. One patient required port repositioning under fluoroscopic guidance. The mean follow-up was 16 months (range, 3-34). There was no mortality or significant postoperative complications.
The absence of significant nutritional deficiency, the continued adjustability, and potential reversibility of LAGB make it the safest, least invasive, and most effective bariatric surgery that can be offered to the young and adolescent population.

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    • "Similar to the observations of Widhalm et al., we also observed improvements in CRP, an inflammatory biomarker that independently predicts future vascular events [19]. Decreased CRP has been associated with reductions in the occurrence of adverse cardiovascular outcomes [27]. "
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    ABSTRACT: We examined the effect of laparoscopic adjustable gastric banding (LAGB) on weight loss, inflammatory markers, and components of the Metabolic Syndrome (MeS) in morbidly obese adolescents and determined if those with MeS lose less weight post-LAGB than those without. Data from 14-18 yr adolescents were obtained at baseline, 6 and 12 months following LAGB. Significant weight loss and improvements in MeS components were observed 6 months and one year following LAGB. The incidence of MeS declined 56.8% after 6 months and 69.6% after 12 months. There was no significant difference in amount of weight lost post-LAGB between those with and without MeS at either timepoint. Correlations between change in weight parameters and components of MeS in those with and without MeS at baseline were examined and found to vary by diagnostic category. LAGB is effective for short-term improvement in weight, inflammatory markers, and components of MeS in morbidly obese adolescents.
    Journal of obesity 01/2011; 2011(1):906384. DOI:10.1155/2011/906384
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    ABSTRACT: The adverse impact obesity can have on a person's medical and mental health is overwhelming. As the prevalence and severity of childhood obesity and its related comorbidities continue to swell, there are inadequate effective, long-term solutions for the non-surgical management of morbidly obese youth. Although they are still controversial, refined surgical procedures have improved the safety and efficacy of bariatric surgery. It is being increasingly used with morbidly obese adolescents under the care of a multi-disciplinary treatment team. Bariatric surgery typically results in marked weight loss and the resolution or reduction of comorbid conditions. At a more normalized weight, these adolescents often experience substantial life changes in areas that have the potential to positively, and sometimes negatively, alter a person's quality of life. It is important to understand these complex changes in order to facilitate the adolescent's positive long-term outcome. Despite their importance, there are limited empirical studies pertaining to adolescent psychosocial outcomes. Current results support the benefits of bariatric surgery in this population, but more rigorous research studies with prospective data collection and long-term follow up are necessary before pediatric bariatric surgery can be officially sanctioned for this special needs population. CLINICAL FOCUS Primary Psychiatry. 2008;15(8):68-73 FOCUS POINTS • Significant psychological changes follow adolescent bar-iatric surgery. • Psychological factors and quality of life are important outcomes of surgery. • A minority of adolescents exhibit poor psychosocial adjust-ment post-surgery.

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