A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes |
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Authors: | Ai-Xuan Holterman Allen Browne Lisa Tussing Amy Phipps Christiane Stahl |
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Affiliation: | a Department of Pediatrics and Surgery, Section of Pediatric Surgery, Rush University Medical Center, Chicago, IL 60612, USA b The New Hope Pediatric and Adolescent Weight Management Project, University of Illinois Medical Center c Department of Pediatrics, University of Illinois College of Medicine, Chicago, IL 60612, USA |
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Abstract: | Background and Materials and MethodsThe outcome of patients completing 12 months of follow-up in a prospective longitudinal trial of the safety/efficacy of laparoscopic adjustable gastric banding (LAGB) for morbidly obese adolescents aged 14 to 17 years using a Food and Drug Administration Institutional Device Exemption for the use of the LAPBAND was analyzed. Baseline and outcome data were abstracted from a prospective database.ResultsBaseline (mean ± SD) body mass index was 50 ± 10 kg/m2, and excess weight was 178 ± 53 lb in 20 patients. Comorbidities included hypertension (45%), dyslipidemia (80%), insulin resistance (90%), metabolic syndrome (95%), and biopsy-proven nonalcoholic steatohepatitis (88%). At mean (SD) follow-up of 26 (9) months, % excess weight loss was 34% ± 22% (n = 20) and 41% ± 27% (n = 12), and the metabolic syndrome was resolved in 63% and 82% of the patients at 12 and 18 months, respectively. Hypertension normalized in all patients, along with improvement in lipid abnormalities and quality of life scores (P < .05). At 12 months, of the 5 patients with less than 20% excess weight loss, dyslipidemia and metabolic syndrome were resolved in 2 patients.ConclusionAt intermediate follow-up of a LAGB-based obesity treatment program, weight loss led to resolution or improvement of major obesity-related comorbidities in most patients, supporting the efficacy of LAGB as a surgical adjunct to a comprehensive obesity treatment program and its long-term evaluation. |
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Keywords: | BMI, body mass index EWL, excess weight loss HOMA, homeostatic model assessment TG, triglyceride HTN, hypertension IR, insulin resistance LAGB, laparoscopic adjustable gastric banding MS, metabolic syndrome QOL, quality of life SBP, systolic blood pressure |
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