The aim of this study is to evaluate the safety and efficacy of the Laparoscopic Sleeve Gastrectomy in the adolescent obese population.
Obesity is a chronic and progressive disease, associated with related metabolic disorders, causing severe morbidity and mortality among children and adolescents. Population studies in the last few decades have demonstrated a dramatic and progressive increase in the proportion of obese adolescents. The increased rate of adolescent obesity is especially troubling since obese children and adolescents have a 25% greater risk of progression to adult obesity .With the proven success of bariatric surgery and the explosive increase in procedures performed in the last two decades, the issue of bariatric surgery for the adolescent population is gaining interest but is still controversial with limited scientific data (9). Prominent points of concern are the effect of bariatric surgery on normal growth and sexual development, as well as the psychological implications (10). Laparoscopic sleeve gastrectomy (LSG) is a relatively new procedure for obesity. The majority of stomach along the greater curvature is removed, with a remnant upper gastrointestinal tract to maintain integrity to a certain extent. LSG gains advantage over other procedures with its simplicity, comparable results, short duration of operation, and less complications (11). It has been accepted gradually by doctors and patients and has recently become more popular (12-13). This study aims to assess the safety and efficacy of laparoscopic sleeve gastrectomy in the adolescent obese population in two Lebanese hospitals.
This study is a retrospective observational study that uses data collected from January 2011 till September 2014. All adolescent patients who were less than (or equal) 21 years of age at the time of the study and have undergone laparoscopic sleeve gastrectomy at the American University of Beirut Medical Center and in Makassed General Hospital were included after respective Institutional Review Board approval. Demographic data, anthropomorphic data (weight, height, BMI) and detailed postoperative history were obtained and analyzed using the Statistical Package for the Social Science (SPSS). Weight loss was registered as change in body mass index (BMI) and percentage of excess weight loss ( % EWL). BMI was calculated as weight divided by height2. %EWL was calculated using the formula 100% x (initialweight – follow upweight )
(Initialweight – IBW) where Ideal body weight (IBW) was considered as the weight needed to achieve a BMI of 25 kg/m2. Results were represented as mean ±standard deviation (SD). Statistical significance was defined as P <0.05.
Our study shows that LSG is an effective and safe weight loss procedure for morbidly obese adolescents offering good weight loss outcomes and significant resolution of many obesity related comorbidities. However, it necessitates appropriate and cautious patient selection, management, and follow-up. Moving forward, prospective studies that assess the quality of life of these patients on long-term follow up are recommended especially that data on the psychological impact of bariatric surgery in adolescent is scarce.