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Perioperative Course, Weight Loss and Resolution of Comorbidities After Primary Sleeve Gastrectomy for Morbid Obesity: Are There Differences Between Adolescents and Adults?

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Abstract

Background

Morbid obesity in both adolescents and adults has risen in an alarming rate. Bariatric surgery is playing an increasing role in pediatric surgery. However, current evidence is limited regarding its safety and outcome.

Methods

Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered. For the current analysis, all adolescent and adult subjects that had undergone laparoscopic sleeve gastrectomy (LSG) from 2005 to 2014 were considered.

Results

LSG represents the most common bariatric procedure in Germany with a proportion of 48.1% in adolescent and 48.7% in adult obese in 2014. LSG was performed in 362 adolescent and 15,428 adult subjects. Pre-operative BMI was comparable between the two populations. However, adult obese had more frequently coexisting comorbidities (p < 0.01). Complication rates and mortality (0 vs. 0.2%) did not differ significantly. Adolescents achieved a BMI reduction of 16.8 and 18.0 kg/m2 at 12 and 24 months compared with 15.4 and 16.6 kg/m2 in the adult group. There was a significantly higher BMI reduction in late adolescents (19–21 years) compared with patients ≤18 years at 24 months (19.8 vs. 13.6 kg/m2). Resolution rate of hypertension was significantly higher in adolescents.

Conclusion

LSG is a safe therapeutic option that can be performed in adolescents without mortality. Late adolescents experienced the highest weight loss; resolution rate of comorbidities was lower in adults. All future efforts should now be focused on the evaluation of the long-term outcomes of LSG in the pediatric population.

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Acknowledgements

The German Nationwide Survey on Bariatric Surgery was supported by the Ministry of Research and Education Germany (BMBF) grant number 01GI1124. The responsible investigator is C. Stroh. We thank all hospitals that actively participated in the study.

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Authors and Affiliations

  1. Department of Surgery, University Hospital Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany

    Frank Benedix, Thomas Krause, Stefanie Wolff & Hans Lippert

  2. StatConsult Magdeburg, Halberstädter Strasse 40a, 39112, Magdeburg, Germany

    Daniela Adolf

  3. SRH Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany

    Thomas Manger & Christine Stroh

Authors
  1. Frank Benedix
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  2. Thomas Krause
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  3. Daniela Adolf
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  4. Stefanie Wolff
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  5. Hans Lippert
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  6. Thomas Manger
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  7. Christine Stroh
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Consortia

Obesity Surgery Working Group, Competence Network Obesity

Corresponding author

Correspondence to Frank Benedix.

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Conflict of Interest

The authors declare that there are no conflicts of interest.

Grant Support

The following firms support the GBSR without any relation to their products: Johnson & Johnson Medical GmbH, Ethicon Endo-Surgery, Norderstedt, Germany, and Covidien GmbH, Neustadt/Donau, Germany.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Benedix, F., Krause, T., Adolf, D. et al. Perioperative Course, Weight Loss and Resolution of Comorbidities After Primary Sleeve Gastrectomy for Morbid Obesity: Are There Differences Between Adolescents and Adults?. OBES SURG 27, 2388–2397 (2017). https://doi.org/10.1007/s11695-017-2640-7

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  • DOI: https://doi.org/10.1007/s11695-017-2640-7

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