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Laparoscopic sleeve gastrectomy curbs pediatric obesity

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Laparoscopic sleeve gastrectomy (LSG) prompts weight loss in most severely obese children and adolescents, Saudi Arabian researchers report in an April 16th on-line paper in the Annals of Surgery.

Moreover, Dr. Aayed R. Alqahtani told Reuters Health by email, “Sleeve gastrectomy has better outcomes in terms of weight loss compared to gastric banding and has less complications than gastric bypass. In our group we found that these kids grow well without any malnutrition. I feel it is the best option nowadays for morbidly obese children and adolescents compared to other weight loss surgeries.”

Dr. Alqahtani and colleagues at King Saud university, Riyadh, assessed the efficacy of the method by reviewing data on 108 patients aged 5 through 21 years who had had LSG between 2008 and 2011. The team notes that “After experiencing notable success with LSG in our adult patients, we began offering LSG as a primary surgical procedure for our morbidly obese pediatric patients.”

In 88 patients evaluated at 3 months, median excess weight loss (allowing for height increase) was 28.9%. In 41 patients at 12 months, it was 61.3% and in 8 patients at 24 months, the loss was 62.3%. Moreover, at 6 months, 42.1% of patients achieved at least a 50% excess weight loss. This was true of 73.2% at 12 months.

There were no serious postoperative complications and no adverse sequelae developed during follow-up. This is in contrast to findings in some studies of laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB).

Weight loss finding, however, compare well to those with RYGB and LAGB.

There also was a resolution of comorbidities, including dyslipidemia (70%) and hypertension (75%).

The approach, continued Dr. Alqahtani “demonstrated substantial excess weight loss in more than 90% of the cases. It cured diabetes, hypertension, sleep apnea, and other life-threatening obesity-related diseases in up to 100% of cases.”

In fact, he concluded, “I have seen children crippled with their obesity who were on wheelchairs, unable to go to school, even having multiple cardiac arrest due to their sleep apnea and other obesity-related morbidities and this surgery has changed their life by curing their problem. I feel it gives new hope to obese children without serious complications.”

SOURCE:

Laparoscopic Sleeve Gastrectomy in 108 Obese Children and Adolescents Aged 5 to 21 Years

Ann Surg 2011.