NEW YORK (MedscapeWire) May 23
Two approaches to morbid obesity presented on May 20 and May 22 at Digestive Disease Week in San Francisco, California, offer new hope of limiting this burgeoning epidemic.
One study suggests that bariatric surgery is as safe in adolescents as it is in adults. The other indicates that an intragastric balloon may help improve outcome or obviate the need for surgery in patients failing medication and counseling.
“Severe obesity is increasing rapidly in adolescents and is associated with significant comorbidity and social stigmatization,” write Harvey J. Sugerman and colleagues from Richmond, Virginia. Of 32 adolescents meeting National Institutes of Health (NIH) adult criteria for bariatric surgery over a 20-year period, 3 had gastroplasty, 16 had gastric bypass, 3 had distal gastric bypass, and 10 had long-limb gastric bypass. There were no postoperative deaths or leaks.
Early complications included 1 pulmonary embolus, 1 major wound infection, 4 minor wound problems, 3 stomal stenoses that were dilated endoscopically, and 4 marginal ulcers treated with acid suppression. Late complications included 1 bowel obstruction, 4 incisional hernias, and 1 sudden death 6 years after surgery. Two patients needed revisional surgery, 1 for malnutrition and 1 for inadequate weight loss.
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