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Sleeve gastrectomy and childhood obesity: The United Arab Emirates Experience - Abstract

Moustafa Hamchou, Hilal Matta, Bahjat Sahari, Adnan Swid, Ahmed Al-Salem

 

Abstract

Background: Obesity and overweight in children is increasingly common worldwide and known to be associated with morbidity. Dietary manipulation and changing their life style may prove to be effective in slightly overweight children but are not effective in obese children and those with comorbidities.

Patients and method: This is a retrospective study of all morbidly obese children who had laparoscopic sleeve gastrectomy (LSG).

Results: Over a period of 4 years (June 2012 - June 2015), 26 children (14 female: 12 male) had LSG. Their mean age was 12.6 years (10.5-15 years) and their mean BMI 47.2 (40-65). Twenty-one (80.8%) of our patients had associated comorbidities. These included sleep apnea (7 patients), hypertension (3 patients), type 2 diabetes mellitus (3 patients), bronchial asthma (4 patients), enuresis (2 patients), and foot and joint problems (2 patients). Two of our patients had Prader–Willi syndrome. The mean follow-up was 1.5 years (1 year - 3 years). The mean operative time was 120 minutes (90-150 minutes). The mean hospital stay was 4 days (3-7 days). Only one of our patients was admitted to the intensive care unit for one day observation because of severe sleep apnea. There were no major complications and no leaks. There was an overall 65.2% weight loss and 70% improvement in comorbidities. Their mean postoperative BMI was 30.75 (24-38). There was also marked improvement in quality of life, self-esteem, productivity and social functioning. There was a significant weight loss in the two patients with Prader–Willi syndrome for the first 2 years but one of them restarted to gain weight again.

Conclusions: Obesity and overweight in children is common worldwide and known to be associated with morbidity. LSG is effective in treating obese children and alleviating their comorbidities. LSG should be performed by experienced laparoscopic surgeons and long term follow-up is important as there is still concern regarding its effects on growth and maturity, and the sustainability of the weight loss.

Keywords:bariatric surgery, children, sleeve gastrectomy, weight loss

 

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