Bariatric surgery for adolescents: initial experience of a center

Carla Vasconcelos1, Ana Reis Melo1, Sónia Silva1, Cláudia Silva1, António Guerra1, John Preto2, Miguel Campos3, Maria do Céu Espinheira1
1Serviço de Pediatria, Centro Pediátrico, Centro Hospitalar São João, Porto
2Serviço de Cirurgia Geral, Centro Hospitalar São João, Porto
3Serviço de Cirurgia Pediátrica, Centro Pediátrico, Centro Hospitalar São João, Porto

 Background and aims 
The prevalence of obesity in pediatric age has been increasing, being an independent risk factor for early morbidity and mortality. Bariatric surgery has been presented as the most effective intervention in the consistent reduction of weight and improvement of cardiovascular and metabolic comorbidities in patients with morbid obesity. We present  the results of the initial experience of implementing a bariatric surgery program for adolescents.

Methods
Adolescents undergoing bariatric surgery were retrospectively evaluated for a period of 3 years. Changes in body weight, coexisting conditions, cardiometabolic risk factors and postoperative complications were analyzed. 
 
Results
Thirteen patients underwent bariatric surgery, one a Roux-en-Y gastric bypass and twelve a sleeve gastrectomy. The mean baseline age was 17.1±0.9 years, and the mean body-mass index was 49,7±4.2 kg/m2 (variable between 42.6 and 59.2). Major cardiometabolic and respiratory comorbidities were a concern in almost all of the adolescents. There were no surgical complications. With a post-surgery period ranging from 2 to 36 months, there was an average weight loss of 32.7±8.7% of the initial weight (variable between 15.1 and 56.5%) and improvement of associated comorbidities, namely elevated blood pressure, insulin resistance, dyslipidemia, hepatic steatosis and obstructive sleep apnea. After bariatric surgery, iron deficiency was observed in one patient and three developed vesicular lithiasis, two of them undergoing cholecystectomy.
 
Conclusions
The initial experience of a Bariatric Surgery Program for teens allowed a considerable reduction in weight as well as a significant improvement of comorbidities in morbidly obese adolescents with no relevant complications associated with the procedure.

BARIATRIC SURGERY FOR ADOLESCENTS: INITIAL EXPERIENCE OF A CENTER