Bariatric Surgery for morbid obese adolescents - should it be done? Experience from the South Australian Health Service (#52)
Bariatric surgical procedures can lead to significant short term weight loss in adolescents however there is limited data on medium or long term follow up. We aimed to evaluate medium term follow up of adolescents who had laparoscopic adjustable gastric banding (LAGB) in the South Australian Health Service since March 2009 as part of a prospective trial.
Twenty five adolescents were referred for assessment of LAGB (aged 17.1 (0.97), 11 males). Twenty adolescents (BMI 46.56 ± 7.8 kg/m2, BMI z score 2.73 ± 0.36, weight 136.9 ± 27.1 kg and weight z score 2.92 ± 0.5) had LAGB and were longitudinally evaluated after LAGB. Outcome measures included body size, change in co-morbidities, quality of life (QOL) and development of complications. QOL questionnaires (Paeds SQL) were evaluated twice immediate pre-LAGB and 6 months post LAGB.
Adolescents had median follow up post-LAGB 14.8 (range 3-38) months with significant decrease in BMI, BMI z score and weight after LAGB (p=0.02, p=0.0098 and p=0.04, respectively). Mean BMI loss was 6.68 ± 4.55. 1 adolescent did not return for follow up due to social reasons.
13/20 adolescents improved in at least one co-morbidity after LAGB. Liver function tests improved significantly after LAGB (ALT: 67.5 [19-134] IU/L vs 33.7 [8-112] IU/L, p= 0.01). There were no complications with the exception of one wound infection and none of the LAGB required revision. 2/20 have been deemed band failures. Mean overall quality of life scores improved significantly as reported by both adolescents (p=0.01) and parents (p=0.002), but did not reach normal levels.
Adolescents who had LAGB in the South Australian Health Service improved weight status, QOL and co-morbidities. LAGB is a safe and reversible procedure for adolescents in the short to medium term but longer term data is required to evaluate the need of further procedures in adulthood.