Bariatric procedures in adolescents are safe in accredited centers

With the rise of obesity in adolescents, there is an exponential increase in bariatric procedures in this patient population.

The purpose of our study was to examine perioperative outcomes after bariatric surgery in this cohort.

University hospital, involving a large database in New York State.

The Metabolic and Bariatric Surgery Accreditation Quality and Improvement Program public use file was queried to identify all adolescent patients (age <19 years) undergoing primary laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in 2015. We assessed 30-day postoperative complications.

We identified 1072 patients who underwent Roux-en-Y gastric bypass (n = 279) or SG (n = 793). The majority were Caucasian (n = 790) and female (n = 857) with mean body mass index and age of 47.9 ± 8.1 kg/m² and 18.2 ± 1 years, respectively, preoperative hypertension, type 2 diabetes, and obstructive sleep apnea were present in 90 (8.4%), 139 (13%), and 165 (15.4%) of patients, respectively. There was significant difference in preoperative gastroesophageal reflux disease (18.6% versus 13.4%, P = .033), obstructive sleep apnea (19.7% versus 13.9%, P = .02), and body mass index (48.6 ± 7.9 versus 47.6 ± 8.2 kg/m², P = .03) between patients undergoing Roux-en-Y gastric bypass and SG, respectively. Thirty-day reoperation, readmission, and reintervention were reported in 1.5%, 3.3%, and 1.6% of the adolescent cohort, respectively. Four patients (.4%) developed a staple line/anastomotic leak, and 1 patient (.09%) died within 30 days; 93.9% of all adolescent patients experienced an uneventful 30-day recovery. Uneventful recovery was significantly more likely for patients undergoing SG (95.3% versus 90%, P = .001; adjusted odds ratio 2.2, 95% confidence interval 1.31-3.69).

Perioperative safety of bariatric surgery in adolescents in accredited centers is safer than previously reported with low rate of 30-day events. SG is a safer procedure in this patient population.