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Original Investigation |

Perioperative Outcomes of Adolescents Undergoing Bariatric Surgery:  The Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study

Thomas H. Inge, MD, PhD1; Meg H. Zeller, PhD1; Todd M. Jenkins, PhD1; Michael Helmrath, MD1; Mary L. Brandt, MD2; Marc P. Michalsky, MD3; Carroll M. Harmon, MD, PhD4; Anita Courcoulas, MD5; Mary Horlick, MD6; Stavra A. Xanthakos, MD, MS1; Larry Dolan, MD1; Mark Mitsnefes, MD, MS1; Sean J. Barnett, MD1; Ralph Buncher, ScD7; for the Teen-LABS Consortium
[+] Author Affiliations
1Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
2Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas
3Nationwide Children’s Hospital, Columbus, Ohio
4University of Alabama at Birmingham
5University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
6National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
7University of Cincinnati, Cincinnati, Ohio
JAMA Pediatr. 2014;168(1):47-53. doi:10.1001/jamapediatrics.2013.4296.
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Importance  Severe obesity in childhood is a major health problem with few effective treatments. Weight-loss surgery (WLS) is being used to treat severely obese adolescents, although with very limited data regarding surgical safety for currently used, minimally invasive procedures.

Objective  To assess the preoperative clinical characteristics and perioperative safety outcomes of severely obese adolescents undergoing WLS.

Design, Setting, and Participants  This prospective, multisite observational study enrolled patients from February 28, 2007, through December 30, 2011. Consecutive patients aged 19 years or younger who were approved to undergo WLS (n = 277) were offered enrollment into the study at 5 academic referral centers in the United States; 13 declined participation and 22 did not undergo surgery after enrollment, thus the final analysis cohort consisted of 242 individuals. There were no withdrawals.

Main Outcomes and Measures  This analysis examined preoperative anthropometrics, comorbid conditions, and major and minor complications occurring within 30 days of operation. All data were collected in a standardized fashion. Reoperations and hospital readmissions were adjudicated by independent reviewers to assess relatedness to the WLS procedure.

Results  The mean (SD) age of participants was 17.1 (1.6) years and the median body mass index (calculated as weight in kilograms divided by height in meters squared) was 50.5. Fifty-one percent demonstrated 4 or more major comorbid conditions. Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6% of patients, respectively. There were no deaths during the initial hospitalization or within 30 days of operation; major complications (eg, reoperation) were seen in 19 patients (8%). Minor complications (eg, readmission for dehydration) were noted in 36 patients (15%). All reoperations and 85% of readmissions were related to WLS.

Conclusions and Relevance  In this series, adolescents with severe obesity presented with abundant comorbid conditions. We observed a favorable short-term complication profile, supporting the early postoperative safety of WLS in select adolescents. Further longitudinal study of this cohort will permit accurate assessment of long-term outcomes for adolescents undergoing bariatric surgery.

Trial Registration  clinicaltrials.gov Identifier: NCT00474318

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