Background

Obesity is a national health epidemic increasingly affecting adolescents and young children. While bariatric surgery is an established therapeutic option in adults and adolescents, its short and long term outcomes in children, especially those under 14, is underreported.

Methods

14 children under the age of 14 with morbid obesity who underwent laparoscopic sleeve gastrectomy (SG) were evaluated over a 5year period (2015-2019). Patient characteristics, comorbidities, operative outcomes, and long-term follow-up were evaluated by univariate analyses.

Results

Median age at SG was 11.9 [range 8.5-13.4], majority being females (78.6%). 6 patients (42.9%) were under 12 years old. Average total duration of follow up was 10.8 months (+13). There were no operative mortalities. Two patients required early re-exploration for post-operative complications. One patient was readmitted within 30 days for dehydration and thiamine deficiency. All patients experienced a net loss in weight and body mass index (BMI). Median overall %change in BMI was 17.5% [7.6-29.9] with corresponding %change in excess BMI of 32% [12-105]. Idiopathic intracranial hypertension, depression, and obstructive sleep apnea were among comorbidities that improved as early as 6 months. In children under 12, there was a longer duration of follow-up and a higher percentage of weight loss and change in BMI.

Conclusions

Bariatric surgery is a safe and effective method of achieving weight loss in the pre-pubertal period. Although it is not without complications in this population, resolution of comorbidities occurred without mortality or significant morbidity.