Efficacy and Safety of Laparoscopic Sleeve Gastrectomy in Adolescents

Background: Adolescent obesity is increasing worldwide, and the demand for bariatric surgery in this patient population is rising. This study assesses the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in the adolescent (<= 21 years) population in two University hospitals in Lebanon. Methods: We retrospectively reviewed a cohort of 121 adolescent patients who underwent LSG at the American University of Beirut Medical Center and at Makassed General Hospital between January 2011 and September 2014. Results: The study included 119 patients with a median age of 18.6 +/- 2.1 years (range 11-21). Most patients were female (71.4%). Mean preoperative weight and body mass index were 117.9 +/- 24.3 kg and 41.9 +/- 6.6 kg/m(2) (range 32.3-71.0 kg/m(2)), respectively. Follow-up was achieved in 90.6%, 65.9%, and 59.5% at 1, 2, and 3 years, respectively. Mean percentage of total weight loss was 31.5%+/- 8.4%, 32.6%+/- 10.4%, and 29.6%+/- 13.7%, while mean percentage of excess weight loss was 90.1%+/- 28.6%, 89.9%+/- 32.0%, and 82.2%+/- 38.6% at 1, 2, and 3 years, respectively. Diabetes, hypertension, and dyslipidemia resolved in 100%, 62.5%, and 83.3% of patients, respectively, at a mean follow-up of 13.8 +/- 9.1 months. Gastroesophageal reflux disease was reported in 21% of patients followed up at 3 years. The most common long-term complication was symptomatic gallstones necessitating surgical intervention (10.1%). Conclusion: The study shows that LSG is an effective and safe weight loss procedure for morbidly obese adolescents, offering good medium-term weight loss outcomes and significant resolution of obesity-related comorbidities.