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: 1.31). 06/2007; 42(5):894-7. DOI: 10.1016/j.jpedsurg.2006.12.057
Source: PubMed

ABSTRACT 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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    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; 2011:906384. DOI:10.1155/2011/906384
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    ABSTRACT: Background The prevalence of obesity has increased rapidly among adolescents. Bariatric surgery is associated with significant weight loss and improvement in obesity related comorbidities, but may be associated with serious complications. Therefore, attempts on finding a safe and effective bariatric procedure for adolescents are ongoing. Objective Herein, we aimed to evaluate safety and efficacy of laparoscopic gastric plication (LGP) on adolescents. Setting A university and private hospital in Iran. Method A prospective study was performed on adolescents who underwent LGP from 2007 to 2013. Measured parameters included the percentage of excess weight (%EWL), percentage of body mass index (BMI) loss (%BMIL), obesity related comorbidities, operative time and length of hospitalization and complications. Result LGP was performed in 12 adolescents (9 female and 3male). Mean (SD) age of the patients was 13.8±1 years. Mean preoperative weight and BMI were 112.4±19.7 kg and 46.0±4 kg/m2, respectively. Mean (SD) %EWL and %EBMIL were 68.2± 9.9% and 79.0± 9.0%, respectively after 2 years. All medical comorbidities were improved after LGP. There were no deaths. One patient required replication 4 days postoperatively due to obstruction at the site of the last knot. No other major complications were observed. No patient required re-hospitalization. Conclusion LGP has the potential of being an ideal weight loss surgery for adolescents, resulting in excellent weight loss and minimal psychological disruption. It is associated with, a minimal risk of leakage, bleeding and nutritional deficiency. However, large well-designed studies with long-term follow-up are needed.
    Surgery for Obesity and Related Diseases 03/2014; 10(6). DOI:10.1016/j.soard.2014.02.039 · 4.94 Impact Factor
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    ABSTRACT: Background Bariatric surgery has shown to be an effective weight loss treatment in morbidly obese adolescents. We compared outcomes of laparoscopic adjustable gastric band (LAGB) to laparoscopic vertical sleeve gastrectomy (VSG). Methods A single institution, retrospective evaluation of a prospectively collected database of LAGB and VSG patients. Results 174 morbidly obese patients underwent bariatric surgery at our institution between 2006 and 2013. 137 patients underwent LAGB and 37 underwent VSG. There were no significant differences between LAGB vs. VSG groups on day of surgery for age, gender, ethnicity, weight, and BMI. At 24-month follow up, patients who underwent VSG vs. LAGB displayed significantly greater percent excess weight loss (70.9 ± 20.7 vs. 35.5 ± 28.6, P = 0.004) and percent preoperative BMI loss (32.3 ± 11.0 vs. 16.4 ± 12.7, P = 0.004). Both VSG and LAGB significantly improved levels of HDL, HgA1c, and fasting glucose. LAGB patients had more complications than VSG patients. Conclusion Bariatric surgery is an effective treatment strategy in morbidly obese adolescents who have failed medical management. VSG results in greater short term weight and BMI loss when compared to LAGB. Longer follow up with more patients will be required to confirm the long term safety and efficacy of VSG in adolescent patients.
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