ESPE Abstracts (2015) 84 P-2-337


Laparoscopic Sleeve Gastrectomy in Adolescents: Metabolic Consequences

Marina Ybarra, Ruth Franco, Louise Cominato, Manoel Carlos Velhote & Durval Damiani


Instituto da Criança, HC, FMUSP, São Paulo, São Paulo, Brazil

Background: Severe obesity (SO), defined as BMI ≥95th percentile, has increased worldwide among adolescents. American studies estimated that 1.3–2.8% of 12–19-year-old individuals have a BMI >40 kg/m2 or a BMI >35 kg/m2 with at least one serious co-morbidity. The immediate and long-term risks associated with SO in adolescents include cardiovascular and metabolic diseases, obstructive sleep apnoea, and nonalcoholic fatty liver disease. However, the results of sleeve gastrectomy in adolescents are still uncertain.

Objective and hypotheses: We aimed to assess the safety, efficacy, and metabolic changes of laparoscopic sleeve gastrectomy in adolescents with SO.

Method: Longitudinal retrospective study of 23 adolescents with SO who underwent laparoscopic sleeve gastrectomy. Clinical and metabolic variables immediately before surgery and after 6, 12, 18, and 24 months were assessed.

Results: Seventeen females and six males between 13 and 18 years old were followed-up for a mean of 2 years. At the initial evaluation, the mean BMI was 44 kg/m2 and the mean weight was 120 kg. The 6-, 12-, 18-, and 24-month mean BMI and weight were respectively, 35.1, 34.9, 34.3, and 37.4 kg/m2 (P<0.0001) and 97.1, 96.6, 95.2, and 102.3 kg (P<0.0001). Leptin, insulin, HDLc, triglycerides, and hepatic enzymes improved at 24 months of follow-up compared to prior surgery levels (P<0.05). One patient presented with unexplained iron deficiency anemia during the follow-up. No other complications were observed.

Conclusion: Laparoscopic sleeve gastrectomy in adolescents with SO seems to be a safe and effective procedure associated to weight and BMI loss and significant metabolic improvement in the first two years.

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