Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: a Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3years Follow-Up.

Abstract

Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. A systematic review was conducted to pool available data on the longest available (>3years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery. A total of 14 studies reporting the result of bariatric surgery after 3years in 950 morbidly obese adolescents were included. Preoperative age and BMI ranged from 12 to 19years and from 26 to 91kg/m2, respectively. Females were the predominant gender (72.8%). Laparoscopic roux-en-Y gastric bypass (n=453) and adjustable gastric banding (n=265) were the most common bariatric procedure performed. The number of patients at the latest follow-up was 677 (range from 2 to 23years). On average, patients lost 13.3kg/m2 of their BMI. Among comorbidities, only diabetes mellitus resolved or improved dramatically. Of 108 readmissions, 91 led to reoperation. There was a weight regain <5kg/m2 between 5 and 6years of follow-up. Removal, exchange, or conversion of the previous band constituted the majority of the revisional procedures. Three deaths were reported. No long-term data was obtainable on nutritional deficiency or growth status of adolescents who underwent a bariatric procedure. Although bariatric surgery is a safe and effective procedure in the treatment of adolescent morbid obesity, long-term data is scarce regarding its nutritional and developmental complication in this growing population of patients.