Morbidity and Mortality after Bariatric Surgery in Adolescents Versus Adults. J Surg Res 2020 Dec;256:180-186
Date
07/28/2020Pubmed ID
32711173DOI
10.1016/j.jss.2020.06.032Scopus ID
2-s2.0-85088125837 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
BACKGROUND: Despite the increasing prevalence and severity of childhood obesity, the national utilization of adolescent bariatric surgery has plateaued. Concern about the perioperative safety of adolescent bariatric surgery has limited referrals and insurance coverage. The purpose of this study was to compare the 30-d complication rate of minimally invasive bariatric surgery in adolescents and adults.
MATERIALS AND METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures in adolescents and adults. Adolescents were defined as age 19 y or younger. Univariate analyses were performed to determine if there was an increased incidence of the adolescent 30-d complication rate as compared with adults.
RESULTS: Of the cases who met inclusion criteria, 1076 (0.8%) were adolescents and 142,704 (99.2%) were adults. Laparoscopic sleeve gastrectomy was the most commonly performed procedure for both patient populations, although at a higher rate in adolescents (73.9% versus 68.8% in adults, P = 0 < 0.0001). The overall 30-d complication rate was comparable in adolescents and adults (6.3% versus 7.3%; P = 0.21) with similar rates of intervention, reoperation, readmission, and mortality. There was no significant difference in any specific perioperative complication class reported between adolescents and adults, except wound disruption (0.2% versus 0.0%, P < 0.0001) and postlaparoscopic sleeve gastrectomy coma >24 h (0.1% versus 0.0%, P < 0.0001).
CONCLUSIONS: Bariatric surgery in adolescents shares a similar perioperative safety profile as found in adults. This data support the utilization and extension of adult criteria for bariatric surgery to adolescents with morbid obesity.
Author List
Lopez EH, Munie S, Higgins R, Gould J, Kindel TAuthors
Jon Gould MD Chief, Professor in the Surgery department at Medical College of WisconsinTammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Age Factors
Bariatric Surgery
Female
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Obesity, Morbid
Patient Readmission
Pediatric Obesity
Postoperative Complications
Reoperation
Treatment Outcome
United States
Young Adult
