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Laparoscopic sleeve gastrectomy safe in children with severe obesity
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Children and adolescents with severe obesity who underwent laparoscopic sleeve gastrectomy at a children’s hospital without NIH support experienced safety outcomes similar to those of NIH-funded bariatric surgery studies in children, according to a retrospective analysis published in Clinical Obesity.
“Bariatric surgery is safe in adolescents, even at a children’s hospital that is neither associated with an adult bariatric surgery program nor supported by the NIH to do research on these patients,” Evan Nadler, MD, director of the adolescent bariatric surgery program and co-director of Children's National Obesity Institute, told Endocrine Today. “The biggest clinical implication is that those who have not recommended bariatric surgery to adolescents for fear of the dangers associated with the procedure need no longer do so. A patient of any age — if they meet standard criteria for weight-loss surgery — should be referred to a surgeon so that they may, at a minimum, learn about the surgical options.”
Nadler and colleagues analyzed data from 105 children and adolescents who underwent laparoscopic sleeve gastrectomy between January 2010 and June 2015 (mean age, 17 years; 57.1% black; mean BMI, 51 kg/m²). Researchers reviewed length of hospital stay, as well as morbidity and mortality data in the 30 days after surgery.
Median length of hospital stay for the cohort was 2 days; there were no deaths in the 30 days after surgery. Three patients (2.9%) experienced major complications during their initial hospital stay requiring reoperation (gastric leak, epigastric bleeding and hemorrhage from a splenic parenchymal laceration); one patient experienced major complications in the 30 days after surgery (deep venous thrombosis). Four patients (3.8%) experienced minor complications, including one submucosal hematoma requiring 2 weeks of total parenteral nutrition, and three patients with decreased oral intake, requiring readmission for IV fluids and steroids.
“Long-term efficacy data are still lacking, but all of the data to date suggest that adolescents do at least as well, if not better, than adult patients after bariatric surgery,” Nadler said. “We need more data to confirm these findings, and research on how to best optimize surgical outcomes in all ages.” – by Regina Schaffer
For more information:
Evan Nadler, MD, can be reached at the Children’s National Medical Center, 111 Michigan Ave., NW, Washington, D.C., 20010; email: enadler@childrensnational.org.
Disclosure: The researchers report no relevant financial disclosures.
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