Journal of Obesity & Weight Loss Therapy
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: Obesity in adolescents increased dramatically and has become commonplace in the last decade. Children with
percentile tend to become obese adults with more health complications, as well as higher mortality rate than those
who become obese in adulthood. Nonoperative managements through a well-supervised diet, psychological counseling, and
physical activity program have been shown to have poor long-term sustainability and low success rate in significant percentage of
adolescents. Laparoscopic adjustable gastric banding (LAGB) is considered a minimally invasive procedure that does not alter the
anatomy and physiology of the intestine, therefore it is considered safer in pre-adult population. We designed a study to evaluate
the current outcomes of LAGB in obese adolescents.
: Using PubMed, MEDLINE, and CHINAHL databases, a systematic review of 14articles from 2005 to 2012 was
performed. Keywords used were adolescent, children, and laparoscopic gastric banding. The primary endpoint was long-term
weight loss outcome of LAGB for treatment of morbid obesity in adolescents.
: A total number of 617 morbidly obese adolescents were included in this analysis with average BMI of 46.74kg/m2. Mean
operative time was 62.7 minutes and length of hospital stay was 32.88 hours. Overall complications were seen in 76 patients
(12.32%), which included band slippage or pouch dilation 30(39.47%), vitamin or mineral deficiency 11(14.47%), problems with
port requiring revision 8(10.53%), gastroesophageal reflux 5(6.58%), dehydration 4(5.26%), band leakage 3(3.95%) and others
7(9.2%). At 3, 6, 9, 12, 18, 24, 36, 48, and 60 months postoperatively, average excess weight loss was 22%, 28.75%, 32%, 43.03%,
52.17%, 50.98%, 60.78%, 63%, and 66.2%, respectively. Suboptimal excess weight loss outcome after LAGB is more frequently
related to lack of social supports, failure to change eating habits, and failure to incorporate recommended exercise.
: LAGB is safe and effective in morbidly obese adolescent to achieve adequate excess weight loss with acceptable rate
of postoperative complications.
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