Efectos sobre el perfil metabólico, el índice de masa corporal, la composición corporal y la comorbilidad en adolescentes con obesidad mórbida, que han fallado al manejo conservador para bajar de peso, operados de manga gástrica laparoscópica. Reporte del primer grupo de cirugía bariátrica pediátrica en México

Abstract

Obesity is a world pandemic; in Mexico 3 out of 10 adolescents suffer from it. Conservative management of morbid obesity is not effective and bariatric surgery is the only useful therapy. International pediatric bariatric surgery series are scarce and in Mexico there is limited experience. We analyze the metabolic repercussions, comorbidities and complications in our series of Mexican adolescents with morbid obesity who underwent a gastric sleeve between 2011 and 2015. 54 morbid obese adolescents were included, 10 fulfilled criteria for surgery. 5 were male, mean age 14.3 ± 1.4 years, weight 117.3 ± 15.2 kg, initial body mass index 43.71 ± 4.1, waist 130.3 ± 6.8 cm, 8 dyslipidemia, 6 metabolic syndrome, 5 liver steatosis, 4 hypertension, 3 type-2 diabetes. Complications: 2 atelectasis, 1 fistula, 1 pneumonia, 1 cholelithiasis; no patient developed nutritional deficits. Weight loss of 33% one-year after surgery and 23% at 2 years. Body fat decreased 22.4% and water content increased 36.1%. Excess weight loss was significant p = 0.001. Two-years after surgery severe steatosis and diabetes had subsided, lipid profile improved and only one patient remained hypertensive. Our results demonstrate that all serious comorbidities associated to morbid obesity were improved (diabetes, dyslipidemia and hypertension) and will confer a better prognosis for these children. Gastric sleeve is useful in morbid obese adolescents. Longer follow-up is needed.