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. 2022 Aug;57(8):1654-1659.
doi: 10.1016/j.jpedsurg.2021.08.018. Epub 2021 Sep 5.

How safe is adolescent bariatric surgery? An analysis of short-term outcomes

Gerard D Hoeltzel  1 , Robert A Swendiman  2 , Colleen M Tewksbury  3 , Elizabeth Prout Parks  4 , Noel N Williams  2 , Kristoffel R Dumon  4
Affiliations

How safe is adolescent bariatric surgery? An analysis of short-term outcomes

Gerard D Hoeltzel et al. J Pediatr Surg. 2022 Aug.

Abstract

Background: The prevalence of childhood obesity in the U.S. has tripled over the last three decades. However, fewer than 1% of children with severe obesity undergo surgical weight loss interventions each year.

Materials and methods: All patients age 10 to 19 years old who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2015 through 2018 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database were included in this retrospective cohort analysis. The primary outcomes were mortality and overall complications. Procedural trends, readmission and reoperation rates were also examined using a multivariate regression model.

Results: Patients had a mean BMI of 47.3 kg/m2 and 80.0% were either 18 or 19 years old (n = 4,051). There were two reported deaths. Reoperation within 30 days occurred in 1.1% of patients, readmission in 3.5%, and complications in 1.2%. Among all readmissions, primary reasons included nausea/vomiting or nutritional depletion (41.3%) and abdominal pain (16.3%). RYGB was associated with higher odds for readmission (p = 0.006) and complications (p = 0.005). Higher BMI and younger age were not associated with an increased likelihood to experience poorer outcomes. The proportion of patients undergoing SG increased yearly over RYGB from 73.9% in 2015 to 84.3% in 2018.

Conclusions: Bariatric surgery appears to be low risk for adolescents and SG has become the operation of choice. More research on early consideration of surgical therapy in adolescents with severe obesity is needed given the safety profile.

Level of evidence: III.

Keywords: ASMBS, American Society for Metabolic and Bariatric Surgery; Abbreviations:; Adolescent; BMI, Body mass index; Bariatric surgery; CI, Confidence Interval; GERD, Gastroesophageal reflux disease; OR, Odds Ratio; Obesity; RYGB, Roux-en-Y gastric bypass; SG, Sleeve gastrectomy; SSI, Surgical site infection; Safety; Sleeve gastrectomy.

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Conflict of interest statement

Disclosures The authors have no financial interests to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. All authors have approved this final article for submission.