Obese teenagers treated by Lap-Band System: The Italian experience

Background. Little is known about obesity surgery in young and adolescent patients. The aim of this study is to evaluate results of laparoscopic adjustable gastric banding in obese teenagers. Methods. Patients <= 19 years old selected from the database of the Italian Collaborative Study Group for Lap-Band were analyzed according to mortality, comorbidities, laparotomic conversion, intra- and postoperative complications, body mass index (BMI), and % excess weight loss (EWL) at different times of follow up. Data were expressed as mean +/- SD. Results. Fifty-eight (1.5%) of 3813 patients who underwent operatian with the Lap-Band System were <= 19 years old: 47F/11M; mean age, 1796 +/- 0.99 years (range, 15-19); mean BMI, 46.1 +/- 6.31 Kg/m(2) (range, 34.9-69.25); mean. % excessweight, 86.4 +/- 27.1 (range, 34-22653).Sixteen (27.5%) of the 58 patients were superobese (BMI >= 50). In 27/58 (46.5%) patients, 1 or more comorbidities were diagnosed. Mortality was absent. Laparotamic conversion was necessary, in 1 patient with gastric perforation, on the anterior wall. Overall postoperative complications occurred in 6/58 (10.3%). The band was removed in 6158 (10.3%) patients for gastric erosion (3 patients), psychologic, intolerance (2 patients), and in the remaining patient was converted 2 years after surgery, (BMI 3 1) to gastric bypass or gastric pouch dilatation. Patient follow-up at 1, 3, 5, and 7 years was 48/52 (92.3%), 37/42 (88.1%), 25/33 (75.7%), and 10/10, respectively. At these times, mean BMI was 35.9 +/- 8.4, 37.8 +/- 11.27, 34.9 +/- 12, and 29.7 +/- 5.2 Kg/m(2). Mean %EWL at the same time was 45.6 +/- 29.6, 39.7 +/- 29.8, 43.7 +/- 38.1, and 55.6 +/- 29.2. Five/25 (20%) patients had <= 25% EWL at 5 years follow-up, while none of the 10 patients subject to follow-up at 7 years had <= 25% EWL. Conclusions. Lap-Band System is an interesting option for teenagers suffering obesity and its related comorbidities, which deserves further investigation.