It is with great pleasure that I welcome Dr Justin Bessell to the newsletter. Dr Bessell is a General and Upper Gastrointestinal Surgeon who is highly experienced in Bariatric surgery. A keen follower of research in the area of weight loss surgery, he will provide guest reports and updates on the latest research. For more on Dr Bessell please visit his profile.
Bariatric Surgery May Be Helpful in Paediatric Population
Bariatric surgery may be effective in obese children and adolescents, but a cautious approach is warranted, according to the results of a systematic review reported online March 3 in Clinical Obesity.
The investigators included 37 studies with a total of 831 children or adolescents younger than 19 years, spanning 36 years. Among 13 studies of gastric banding, mean decreases in body mass index (BMI) ranged from 8.5 to 43, with weight gain reported in 1 case study. Mean BMI reductions ranged from 9 to 25 in 8 studies of gastric bypass (RYGB).
(Other forms of bariatric surgery, including sleeve gastrectomy, vertical banded gastroplasty, biliopancreatic diversion, or a combination of procedures, were reported in 14 articles. These procedures resulted in mean BMI decreases ranging from 9 to 24, weight regain in several cases, and 3 deaths related to surgery.)
One Australian project studied cost-effectiveness, and results reported that laparoscopic adjustable gastric banding (LAGB) is cost effective for adolescents.
The authors stated that existing evidence … suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life.
The authors cautioned that, postoperative complications, compliance and follow-up may be more problematic in adolescents than adults, and availability of long-term data on safety, effectiveness and cost-effectiveness remains largely unknown. The authors suggested a cautious approach to child and adolescent bariatric surgery is warranted, and reversible techniques are advisable compared to approaches that permanently alter anatomy.
The authors went on to say that lifestyle modification is crucial to the long-term success of bariatric procedures.
Prevention was also considered important; they recommended development of practical lifestyle programs for overweight and obese children.
The project that led to this study was funded by the WHO Health Evidence Network of the World Health Organization. The study authors have disclosed no relevant financial relationships.
Clin Obesity. Published online March 3, 2011.
