Obese teenagers treated by Lap-Band System: The Italian experience

• Published in: Surgery 2005-11, Vol.138 (5), p.877-881
• Main Authors: Angrisani, L., Favretti, F., Furbetta, F., Paganelli, M., Basso, N., Doldi, S.B., Iuppa, A., Lucchese, M., Lattuada, E., Lesti, G., Capizzi, F.D., Giardiello, C., Di Lorenzo, N., Veneziani, A., Alkilani, M., Puglisi, F., Gardinazzi, A., Cascardo, A., Borrelli, V., Lorenzo, M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Comorbidity; Databases, Factual; Female; Follow-Up Studies; Gastroplasty - methods; Gastroplasty - mortality; General aspects; Humans; Italy - epidemiology; Laparoscopy; Male; Medical sciences; Metabolic diseases; Obesity; Obesity, Morbid - mortality; Obesity, Morbid - surgery; Treatment Outcome
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2005.07.012

Little is known about obesity surgery in young and adolescent patients. The aim of this study is to evaluate results of laparoscopic adjustable gastric banding in obese teenagers. Patients ≤19 years old selected from the database of the Italian Collaborative Study Group for Lap-Band were analyzed according to mortality, comorbidities, laparotomic conversion, intra- and postoperative complications, body mass index (BMI), and % excess weight loss (EWL) at different times of follow-up. Data were expressed as mean ± SD. Fifty-eight (1.5%) of 3813 patients who underwent operation with the Lap-Band System were ≤19 years old: 47F/11M; mean age, 17.96 ± 0.99 years (range, 15-19); mean BMI, 46.1 ± 6.31 Kg/m 2 (range, 34.9 – 69.25); mean % excess weight, 86.4 ± 27.1 (range, 34 – 226.53). Sixteen (27.5%) of the 58 patients were superobese (BMI ≥50). In 27/58 (46.5%) patients, 1 or more comorbidities were diagnosed. Mortality was absent. Laparotomic conversion was necessary in 1 patient with gastric perforation on the anterior wall. Overall postoperative complications occurred in 6/58 (10.3%). The band was removed in 6/58 (10.3%) patients for gastric erosion (3 patients), psychologic, intolerance (2 patients), and in the remaining patient was converted 2 years after surgery (BMI 31) to gastric bypass or gastric pouch dilatation. Patient follow-up at 1, 3, 5, and 7 years was 48/52 (92.3%), 37/42 (88.1%), 25/33 (75.7%), and 10/10, respectively. At these times, mean BMI was 35.9 ± 8.4, 37.8 ± 11.27, 34.9 ± 12.2, and 29.7 ± 5.2 Kg/m 2. Mean %EWL at the same time was 45.6 ± 29.6, 39.7 ± 29.8, 43.7 ± 38.1, and 55.6 ± 29.2. Five/25 (20%) patients had ≤25% EWL at 5 years follow-up, while none of the 10 patients subject to follow-up at 7 years had ≤25% EWL. Lap-Band System is an interesting option for teenagers suffering obesity and its related comorbidities, which deserves further investigation.