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Bariatric surgery in obese children

Bariatric surgery can be a safe option for obese children

The Saudi researchers also found that in especially the first three years, the bariatric surgery patients had a greater growth spurt than those on a more typical non-surgical weight management programme

Bariatric surgery does not stunt the growth of obese children when applied within a clinical pathway and provides hope for youngsters who are unable to shed pounds through weight management programs that include counselling and lifestyle changes, claims a study published in Obesity Surgery.

Researchers led by Professor Aayed Alqahtani of King Saud University (KSU) in Saudi Arabia, looked at the progress of almost 300 children who had all undergone bariatric surgery through a standardised clinical pathway that was created and applied by Alqahtani in his practice at KSU.

Professor Aayed Alqahtani

In total, 291 children underwent laparoscopic sleeve gastrectomy and followed a clearly defined weight management protocol and guidelines including a multidisciplinary plan of care, guidelines on the surgical techniques to follow and the necessary care that patients should receive before and after the procedure.

The mean age and pre-LSG BMI were 14.4 ± 4.0 years (range; five to 21 years) and 48.3 ± 10.0 (range; 31.8–109.6). Mean BMI change (% excess weight loss) at one, two, three and four postoperative years was −16.9 ± 4.9 (56.6 ± 22.6), −17.5 ± 5.2 (69.8 ± 22.5), −18.9 ± 4.3 (75.1 ± 26.8), and −19.6 ± 6.4 (73.6 ± 24.3), respectively. Postoperatively, complications occurred in 12 patients (4.1 %), with no leaks or mortality, and more than 90 % of comorbidities were resolved or improved without recurrence. Bariatric patients exhibited significantly higher postoperative growth velocity compared to weight management patients.

The Saudi researchers also found that in especially the first three years, the bariatric surgery patients had a greater growth spurt than those on a more typical non-surgical weight management programme. They believe this shows that the procedure has no negative effect on the growth of children and adolescents

"The clinical pathway or guidelines we propose are flexible and are designed to allow tailoring for each patient's specific needs, including those with obesity caused by genetic factors. We recommend that bariatric surgery be used only for children and teenagers who fail weight management and whose obesity is having a major impact on their lives," concluded Alqahtani.

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