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Review

Adolescent Bariatric Surgery

In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
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Review

Adolescent Bariatric Surgery

Sarah Ogle et al.
Free Books & Documents

Excerpt

The prevalence of adolescent obesity has rapidly increased over the past several decades. With this increase, there has also been a rise in the prevalence of complications of obesity leading to premature mortality. While lifestyle and medical management remain a part of the initial treatment of obesity, these therapies have been shown to be inferior when compared to metabolic and bariatric surgery (MBS) for adolescents with severe obesity. A multidisciplinary approach is recommended to evaluate medically eligible candidates for MBS, prepare patients for surgery, and guide postoperative management. Laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most common MBS procedures performed in both adolescent and adult patients. Postoperative hospital stays are generally short and long-term routine follow-up with the MBS team is recommended to monitor weight loss, resolution of complications of obesity, and to monitor for postoperative complications. Most adolescent MBS studies demonstrate an average percent body mass index loss between 25-29% after surgery. This is also associated with resolution or improvement of most complications of obesity at rates that are similar or superior to adult studies. Resolution and prevention of type 2 diabetes mellitus (T2DM) after MBS is a particularly compelling reason to pursue surgical treatment due to the complications from T2DM that occur over a patient’s lifetime as well as the overall burden of health-related costs. These adverse consequences of T2DM can be mitigated by early use of MBS. MBS is generally well tolerated. Complication rates are similar to adult patients therefore it is recommended to refer patients for MBS whenever they are medically qualified. Most common short-term (<30 days) complications include leak, bleeding, and surgical site infections. Most common long-term (>30 days) complications are nutritional deficiencies. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, WWW.ENDOTEXT.ORG.

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References

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