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

• Published in: Obesity surgery Vol. 30; no. 1; pp. 296 - 303
• Main Authors: Blumenfeld, Orit, Beglaibter, Nahum, Geron, Nissim, Dichtiar, Rita, Hazzan, David, Keinan-Boker, Lital, Goitein, David
• Format: Journal Article
• Language: English
• Published: New York Springer US 2020; Springer Nature B.V
• Subjects: Body mass index; Gastrointestinal surgery; Hospitalization; Laparoscopy; Medicine; Medicine & Public Health; Mortality; Original Contributions; Surgery; Teenagers; Complications; Weight loss; Bariatric surgery; Registry; Adolescents; Survival; Follow-up
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-019-04155-1

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/m 2 , 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/m 2 vs. 10.3 ± 5.1 kg/m 2 respectively; p  = 0.0001) and higher rate with BMI < 30 kg/m 2 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.