Clinical Edge

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Bariatric surgery is as safe in adolescents as it is in adults

Key clinical point: Bariatric surgery is a safe option for adolescents.

Major finding: There were no statistically significant differences in peri- or postoperative safety between adolescents and adults who underwent bariatric surgery.

Study details: Review of 1,983 adolescents and 353,726 adults who underwent bariatric surgery at a U.S. center during 2015-2017.

Disclosures: The study received no commercial support. Dr. King had no disclosures.

Citation:

El Chaar M et al. Obesity Week 2019, Abstract A138.

Commentary:

These data are very important because they come from the largest collection of data on adolescents who underwent bariatric surgery at a U.S. center and are nationally representative. When I speak with families about the possibility of performing bariatric surgery on an adolescent, their overriding concern is the procedure’s safety. These numbers on adolescent safety constitute the first safety report for this demographic group from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. The similarity in the rate of adverse events in adolescents, compared with adults, is reassuring. As the database matures, we will get additional insights into the longer-term outcomes of these patients, information that’s very important for families trying to choose treatment for an obese adolescent child.

The comparison of safety outcomes between sleeve gastrectomy and Roux-en-Y gastric bypass appears to favor using sleeves. In obese adolescents the most common complications we see are nonalcoholic fatty liver disease and obstructive sleep apnea, and prior reports have documented that both often improve following sleeve gastrectomy. That fact, plus these new safety findings, may help push the field toward greater sleeve use in adolescents, although the data also show that sleeve gastrectomy is already used in nearly four-fifths of adolescent cases.

Corrigan McBride, MD, is a professor of surgery and director of bariatric surgery at the University of Nebraska Medical Center in Omaha. She had no disclosures. She made these comments in an interview.