A 5-Year Follow-up in Children and Adolescents Undergoing One-Anastomosis Gastric Bypass (OAGB) at a European IFSO Excellence Center (EAC-BS)

Abstract

Background: The children and adolescent population with obesity has increased worldwide, both in developing areas and in developed countries. Consequently, the prevalence of morbid obesity among this population has also increased, leading to an exponential growth of bariatric approaches in this population. Many surgeons fear eventual nutritional sequelae after malabsorptive approaches and prefer restrictive or mixed procedures. Methods: A retrospective review of all the morbidly obese patients between 13 and 19 years, undergoing a one-anastomosis gastric bypass (OAGB) as bariatric procedure between 2004 and 2012, was performed. Results: A total of 39 patients were included, 8 males (20.5%) and 31 females (79.5%), with a mean age of 17.8 ± 2 years (range 13–19 years). Mean preoperative weight was 114.3 ± 20.4 kg and mean BMI 42.2 ± 5.9 kg/m2. Preoperative comorbidities include only type 2 diabetes mellitus (T2DM) in 7.9% of the patients, hypertension in 10.3%, and dyslipidemia in 23.1%. Five years after surgery, mean BMI was 25.9 ± 5.3 kg/m2 and total weight loss 32.1 ± 15.7%. Remission rate of T2DM, hypertension and dyslipidemia was 100%. All the patients received multivitamin and vitamin D supplementation. Anemia secondary to iron deficiency occurred in one female, requiring intravenous iron supplementation during 1 year and later on oral supplementation. Conclusions: OAGB is a valid alternative for long-term weight loss and remission of comorbidities in childhood and adolescence. No cases of malnutrition or growth disorders were observed.