ESPE Abstracts

Background: Obesity is one of these chronic diseases that makes difficulties in achieving a therapeutic effect and maintaining the obtained effect both in respect of lost kilograms and preventing from the development of its associated diseases. The children's population has the primacy of development of this disease. Surgical treatment is an alternative and in many cases the only right solution to ineffective conservative treatment. It is one of the stages of treatment of obesity, which begins to bring the expected results of weight loss. A patient qualified to bariatric treatment must be adequately prepared and have proper care to ensure safety and achieve the desired therapeutic result. Sustaining and maintaining this result requires the patient to closely cooperate with an multidisciplinary team (MDT) of specialists dealing with the treatment of obesity.

Aim: to present the effects of treating children with giant obesity with bariatric surgery.

Patients and Methods: Patients are under the care of MDT, which consists of a pediatrician, endocrinologist, psychologist, surgeon, physiotherapist and dietitians within the outpatient clinics and pediatric departments. For the last 7 years at the Department of Pediatric Surgery and Urology at GCZD in Katowice, surgical treatment has been undertaken in a dozen of children with giant obesity aged 13-19. All operated children were treated conservatively in Obesity Treatment Outpatient Clinic min. 13 months, max. 7 years. None of them achieved a satisfactory loss of body weight despite the habits and lifestyle change, and if it occurred, later the "yo-yo" effect and the return to mass before the implementation of surgical treatment, or increase in the baseline BMI were observed.

Results: After surgery - sleeve resection of the stomach/gastric bypass, a loss of body weight min. 26 kg max. 73 kg. Most of the comorbid diseases diminished and in none of operated the side effects such as vitamin deficiencies, bone structure disorders or gaining weight were observed. Patients were strictly monitored after the surgery according to a precisely planned schedule of tests and follow-up visits. The follow-up period after surgery is right now up from 18 months do 7 years.

Conclusion: Operations in the field of metabolic surgery are effective and, particularly in justified cases, there is no need to postpone this stage of treatment for the adulthood. The proper qualification and careful perioperative care are crucial for the bariatric surgery outcome.