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A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes
Authors:Ai-Xuan Holterman  Allen Browne  Lisa Tussing  Amy Phipps  Christiane Stahl
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
Abstract:

Background and Materials and Methods

The 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.

Results

Baseline (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.

Conclusion

At 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.
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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