Adolescent Gastric Banding: a 5-Year Longitudinal Study.

Abstract

Laparoscopic adjustable gastric banding (LAGB) is used to treat obesity in adults. Less is known about long-term results of the procedure in adolescents. To evaluate LAGB 5-year outcomes in teenagers with severe obesity. Children's hospital, USA. Adolescents (14-18years) underwent LAGB in an FDA-approved observational clinical trial. Outcomes including anthropometric measurements, comorbid conditions, complications, and band retention were collected through 60months. One hundred thirty-seven subjects underwent LAGB (94 female, 43 male; 43% white, 37% Hispanic, 17% black; 4% other). Mean age and body mass index (BMI) pre-operatively were 17.0+1.2years and 48.3+8.2kg/m2, respectively. Comorbidities were present in 71%. Maximum weight loss occurred by 36months (mean % excess weight loss (EWL) 40.6+35.2, mean % excess BMI loss (EBMIL) 41.6+34.9) and was maintained through 5years for most subjects. There were no significant differences in weight loss by gender. Twenty-three (18%) of 127 adolescents reporting at 60months achieved 50% excess weight loss. Postoperative heartburn and emesis occurred in 70% and 32%, respectively. Complications requiring additional surgery occurred 80 times in 63 patients. Thirty-three (26%) of 127 subjects contacted at 5years had undergone band removal. In this study, fewer than 20% of adolescents with severe obesity lost > 50% of their excess weight following LAGB. Nearly 50% of patients required additional surgery. With reports of success following sleeve gastrectomy and gastric bypass, we believe that LAGB is not a preferred choice to treat adolescents with obesity.