Morbidity and Mortality after Bariatric Surgery in Adolescents Versus Adults

Despite the increasing prevalence and severity of childhood obesity, the national utilization of adolescent bariatric surgery has plateaued. Concern about the perioperative safety of adolescent bariatric surgery has limited referrals and insurance coverage. The purpose of this study was to compare the 30-d complication rate of minimally invasive bariatric surgery in adolescents and adults.

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures in adolescents and adults. Adolescents were defined as age 19 y or younger. Univariate analyses were performed to determine if there was an increased incidence of the adolescent 30-d complication rate as compared with adults.

Of the cases who met inclusion criteria, 1076 (0.8%) were adolescents and 142,704 (99.2%) were adults. Laparoscopic sleeve gastrectomy was the most commonly performed procedure for both patient populations, although at a higher rate in adolescents (73.9% versus 68.8% in adults, P = 0 < 0.0001). The overall 30-d complication rate was comparable in adolescents and adults (6.3% versus 7.3%; P = 0.21) with similar rates of intervention, reoperation, readmission, and mortality. There was no significant difference in any specific perioperative complication class reported between adolescents and adults, except wound disruption (0.2% versus 0.0%, P < 0.0001) and postlaparoscopic sleeve gastrectomy coma >24 h (0.1% versus 0.0%, P < 0.0001).

Bariatric surgery in adolescents shares a similar perioperative safety profile as found in adults. This data support the utilization and extension of adult criteria for bariatric surgery to adolescents with morbid obesity.