Long-term outcomes of Roux-en-Y gastric bypass in the adolescent population: a systematic review and single-arm...

Long-term outcomes of Roux-en-Y gastric bypass (RYGB) in adolescents are limited. This systematic review and meta-analysis evaluates the safety and efficacy of RYGB in adolescents with obesity. A comprehensive literature search was conducted across databases, including MEDLINE, EMBASE, Cochrane, and SCOPUS up to July 2023. Included studies reported outcomes for participants younger than 21 years of age undergoing RYGB, with a minimum follow-up of 2 years. A random-effects model was used for pooled analysis. Twelve studies were included involving 522 adolescents. The mean age was 17.5 years (13-21 years), 73.6% of patients were female, and the mean follow-up was 48.4 months. Baseline body mass index (BMI) was 50.1 kg/m². BMI reduction peaked at 1 year with an absolute reduction of 19.1 kg/m², 36.6% total loss, and 67.7% excess BMI loss. At 5 years, absolute reduction of BMI was 19.1 kg/m², percentage loss was 31.5%, and excess BMI loss was 70.5%. Comorbidity remission rates were 85% for dyslipidemia, 73% for hypertension, 85% for type 2 diabetes, and 68% for obstructive sleep apnea. Iron and vitamin B12 deficiency rates were greater postoperatively. The complication rate was 29.1%. RYGB in adolescents leads to significant weight loss and comorbidity resolution but carries risk of complications and requires monitoring for nutritional deficiencies. Further long-term studies are essential.