Bariatric surgery in adolescents - Recent national trends in use and in-hospital outcome

Division of Pediatric Surgery, Department of Surgery, University of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 04/2007; 161(3):217-21. DOI: 10.1001/archpedi.161.3.217
Source: PubMed


To analyze recent nationwide trends in the use of adolescent bariatric surgery and to compare early postoperative outcomes of adolescents and adults undergoing these procedures.
Analysis of national administrative data by using survey analysis techniques.
Data obtained from the Nationwide Inpatient Sample from 1996 to 2003.
Adolescents (aged <20 years) and adults undergoing bariatric surgery. Intervention Bariatric surgery.
Population-based case rates, major postoperative complications, length of hospital stay, hospital charges, and mortality.
The population-based annual adolescent bariatric case volume varied little between 1996 and 2000 but more than tripled from 2000 to 2003. Despite this trend, only 771 bariatric procedures were performed in adolescents in 2003, representing fewer than 0.7% of bariatric procedures performed nationwide. Univariate comparison with data from 2003 showed a similar in-hospital complication rate in adolescents and adults but a significantly shorter length of stay among adolescents. Although in-hospital mortality was observed in 0.2% of adults, no in-hospital deaths were observed in any adolescents.
Although procedure rates have increased recently, bariatric surgery in adolescents remains an uncommonly performed procedure. These data support efforts to align bariatric surgery programs for adolescents initially with higher volume programs for adults and to develop multicenter collaborative studies directed at defining the short- and long-term effect of bariatric surgery in morbidly obese adolescents.

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    • "Preliminary data in adolescents suggest that short-term outcomes for weight loss and improvement of comorbidities are similar to those observed in adults, but further studies are necessary to confirm these results and evaluate long-term outcomes [18,25-28]. Early evidence of safety and efficacy exists for two procedures (adjustable gastric band, Roux-en-Y gastric bypass (RYGB)) [15,29-31]. In principle, the group of adolescent patients with extreme obesity may be particularly vulnerable to long-term complications of surgery; on the other hand the group could potentially maximally benefit via for example enhanced integration into the job market and reduction of social isolation. "
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    • "While it is known that weight reduction associated with anorexia nervosa and bariatric surgery leads to bone loss [8], [9], it is increasingly recognized that additional pathways contribute to the loss of bone resulting from altered nutritional status. Indeed, studies post bariatric surgery have reported that weight accounted for as little as 14% of the loss of bone mineral content, indicating a significant contribution by non-weight bearing factors [10]. "
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    PLoS ONE 07/2012; 7(7):e40038. DOI:10.1371/journal.pone.0040038 · 3.23 Impact Factor
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    • "Bariatric surgery procedures specifically aimed at assisting with weight loss are becoming more popular in adolescents [75]. A review of the literature did not identify any studies evaluating mind-body interventions specifically in pediatric bariatric surgery patients, but research supports the use of such interventions to assist children perioperatively [57] [76]. "
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