Comparative Effectiveness of Laparoscopic Adjustable Gastric Banding vs Laparoscopic Sleeve Gastrectomy in Adolescents—a National Registry-Based Study

Orit Blumenfeld, Nahum Beglaibter, Nissim Geron, Rita Dichtiar, David Hazzan, Lital Keinan-Boker, David Goitein

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Most published work on bariatric surgery (BS) in adolescents describes outcomes after laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass. We compared the efficacy of LAGB and laparoscopic sleeve gastrectomy (LSG) in adolescents. Methods: A National Bariatric Registry was queried for adolescents who underwent BS between June 2013 and December 2015. We collected data on weight and height at baseline and 1-year following surgery, subsequent hospitalizations, interventions, and mortality, which were compared at 30 days post-surgery and until last follow-up (maximum 4.2 years post-surgery). Mortality and hospitalization data were extracted from national databases. Results: Two hundred fifty-nine adolescents (60% females) aged 12–19 years were included. Mean age and body mass index (BMI) were 17.5 ± 1.2 years and 45.1 ± 5.0 kg/m2, respectively. LSG (n = 227, 87.6%) and LAGB (n = 32, 12.4%) were the most common procedures performed. LSG group achieved greater average at 1 year BMI loss compared to LAGB group (15.4 ± 4.7 kg/m2 vs. 10.3 ± 5.1 kg/m2 respectively; p = 0.0001) and higher rate with BMI < 30 kg/m2 1 year post-surgery (57.7% (n = 131) vs. 25% (n = 8), respectively; p = 0.0005). Males who underwent LSG reduced BMI more than their female counterparts (p = 0.0001), LSG was the strongest independent predictor for BMI < 30 after 1 year (OR = 4.1; 95% CI 1.7–9.9) followed by age (OR = 1.3; 95% CI1.0–1.6). No mortality was observed. Postoperative hospitalizations between the two groups did not differ (hazard ratio 2.4; 95% CI 0.7–7.9; p = 0.1). Conclusion: Compared to LAGB, LSG is superior regarding weight loss with a similar risk of short- and long-term hospitalizations, complications, and interventional procedures. Males lose more weight following LSG.

Original languageEnglish
Pages (from-to)296-303
Number of pages8
JournalObesity Surgery
Volume30
Issue number1
DOIs
StatePublished - 1 Jan 2020

Bibliographical note

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Adolescents
  • Bariatric surgery
  • Complications
  • Follow-up
  • Registry
  • Survival
  • Weight loss
  • Humans
  • Israel/epidemiology
  • Male
  • Gastrectomy/adverse effects
  • Young Adult
  • Female
  • Registries
  • Retrospective Studies
  • Weight Loss/physiology
  • Obesity, Morbid/epidemiology
  • Child
  • Databases, Factual
  • Body Mass Index
  • Length of Stay
  • Treatment Outcome
  • Pediatric Obesity/epidemiology
  • Gastroplasty/adverse effects
  • Adolescent
  • Laparoscopy/adverse effects

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Surgery
  • Endocrinology, Diabetes and Metabolism

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