Metabolic and bariatric surgery outcomes in adolescents: a single center's seven-year update

Michael Kochis; Christa Bizimana; Alyssa Stetson; Maimouna Sy; Hang Lee; Vibha Singhal; Denise Gee; Janey S A Pratt; Cornelia L Griggs

doi:10.1007/s00464-024-11273-0

Metabolic and bariatric surgery outcomes in adolescents: a single center's seven-year update

Surg Endosc. 2024 Sep 25. doi: 10.1007/s00464-024-11273-0. Online ahead of print.

Authors

Michael Kochis¹, Christa Bizimana², Alyssa Stetson², Maimouna Sy², Hang Lee³, Vibha Singhal⁴, Denise Gee², Janey S A Pratt⁵, Cornelia L Griggs²

Affiliations

¹ Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. mkochis@mgh.harvard.edu.
² Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
³ Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
⁴ Pediatric Endocrinology and Obesity Medicine, UCLA Mattel Children's Hospital, Los Angeles, CA, USA.
⁵ Department of Surgery, Stanford Hospital, Stanford, CA, USA.

PMID: 39317907
DOI: 10.1007/s00464-024-11273-0

Abstract

Background: Metabolic and bariatric surgery (MBS) is gaining traction as a treatment option for adolescents with severe obesity. Since our weight center last published results in 2014, trends have shown increasingly diverse patient populations undergoing MBS and a shift from laparoscopic Roux-en-Y gastric bypass (LRYGB) to sleeve gastrectomy (LSG). We assessed outcomes including follow-up, weight loss, comorbidity resolution, and complications among our recent adolescent and young adult MBS patients.

Methods: This is a retrospective cohort analysis of patients under 21 years of age with severe obesity who underwent MBS at a single institution between 2014 and 2020. Data on demographics, comorbidities, body mass index (BMI), percent of total body weight loss (%TBWL) at various timepoints, and subsequent complications were collected via chart review. Regression examined associations between preoperative factors, follow-up, and %TBWL.

Results: There were 79 patients of whom 73% were female; overall, 53% were White, 24% Hispanic, and 15% non-Hispanic Black. The majority (80%) of patients underwent LSG. Three-fourths of patients had follow-up data beyond 1 year, and half beyond 3 years. The median %TBWL of LSG patients was 23% at a median follow-up of 3.0 years, and LRYGB patients 28% at 2.4 years. No preoperative factors were associated with follow-up or final %TBWL, but 6-month %TBWL predicted final %TBWL. Preoperatively, 73% of patients had at least one weight-related comorbidity, and 57% had documented improvements in at least one after surgery. There were three 30-day readmissions and no mortalities.

Conclusions: This study, which is an update to a previous series from our center, reflects recent national trends with nearly half non-White patients and predominance of LSG over LRYGB. It adds to a growing body of evidence indicating that MBS is a safe and effective method of achieving weight loss and comorbidity resolution in adolescents with severe obesity.

Keywords: Adolescents; Comorbidities; Laparoscopic sleeve gastrectomy; Metabolic and bariatric surgery; Roux-en-Y gastric bypass; Weight loss.