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Laparoscopic Roux-en-Y gastric bypass in adolescents with morbid obesity-Surgical aspects and clinical outcome.

Artikel i vetenskaplig tidskrift
Författare Gunnar Göthberg
Eva Gronowitz
Carl-Erik Flodmark
Jovanna Dahlgren
Kerstin Ekbom
Staffan Mårild
Claude Marcus
Torsten Olbers
Publicerad i Seminars in pediatric surgery
Volym 23
Nummer/häfte 1
Sidor 11-16
ISSN 1532-9453
Publiceringsår 2014
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för gastrokirurgisk forskning och utbildning
Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Sidor 11-16
Språk en
Länkar dx.doi.org/10.1053/j.sempedsurg.201...
Ämnesord Adolescent, Bariatric, Surgery, Gastric bypass
Ämneskategorier Gastroenterologi, Pediatrik

Sammanfattning

In this paper, we address surgical aspects on bariatric surgery in adolescents from a nationwide Swedish study. Laparoscopic gastric bypass surgery was performed for 81 adolescents with morbid obesity (13-18 years), while 81 adolescents with obesity-matched by age, sex, and BMI received conventional care. Another comparison group was adults undergoing gastric bypass at the same institution during the same time period. This report addresses the 2-year clinical outcome and five-year surgical adverse event rate. Body weight decreased from 133kg (SD = 22) at inclusion to 92kg (SD = 17) after 1 year and was 89 (SD = 18) after 2 years (p < 0·001) representing a 32% (-35 to -30) weight loss after 2 years, corresponding to 76% (-81 to -71) excess weight loss. Weight loss was similar in the adult gastric bypass patients (-31%) while weight gain (+3%) was seen in the conventionally treated obese adolescents. Significant improvement in cardiovascular and metabolic risk factors and inflammation was seen after surgery. The treatment was generally well tolerated and quality of life improved significantly. The surgical adverse events included cholecystectomies (10%) and operations for internal hernia (9%) but no postoperative mortality. Adolescents undergoing laparoscopic gastric bypass surgery achieve similar weight loss to adults. Improvements in risk factors and quality of life were substantial. There were surgical complications similar to the adult group, which may be preventable.

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