Laparoscopic Sleeve Gastrectomy for Adolescents Under 18 Years Old with Severe Obesity

Abstract

Introduction: Laparoscopic sleeve gastrectomy (LSG) is a widely accepted stand-alone bariatric operation. Data on adolescent patients undergoing LSG are limited. The aim of this study was to demonstrate that LSG is safe and effective for patients strictly under 18 years old with severe obesity.

Methods: Prospectively collected data from consecutive patients undergoing LSG were retrospectively analyzed. Patients with more than 1-year follow-up were included in the analysis for weight loss and comorbidity evaluation. Quality of life (QoL) was evaluated using the Short-Form 36 questionnaire.

Results: Eighty-four patients under 18 years old (range: 15-17 years) underwent LSG. Median weight was 128 kg and median body mass index (BMI) 43.7 kg/m². Median duration of surgery was 68.5 min. One major complication was recorded: a patient developed severe pneumonia that necessitated ventilatory support in intensive care unit and intravenous antibiotic treatment. Mortality was null. Median length of hospital stay was 4 days. Six, 12, and 24 months after LSG, median BMI decreased significantly to 34.3, 29.8, and 28.8 kg/m², respectively (p < 0.001), with a mean percentage of total body weight loss of 29.1% at 2 years. Obesity-related comorbidities improved at 1 year, while all SF-36 scale scores of QoL assessment improved significantly.

Conclusion: This study suggests that LSG is safe and effective for patients under 18 years old, resulting in significant weight loss, comorbidity remission, and QoL improvement. Careful patient selection after adequate risk versus benefit evaluation by an expert multidisciplinary team is essential.

Keywords: 18 years old; Adolescents; Bariatric surgery; Laparoscopy; Obesity; Sleeve gastrectomy.