Background

Pediatric patients who undergo bariatric surgery have been shown to have better glycemic control, weight reduction, and improvement of cardiovascular risk factors compared to those treated with medical therapy alone. However, bariatric surgery remains underutilized for this population, especially those aged 13 and under. This retrospective single-center cohort study examines outcomes for this demographic who were evaluated for bariatric surgery and subsequently underwent sleeve gastrectomy.

Methods

A total of 15 patients underwent vertical sleeve gastrectomy at 13 years of age or younger at a tertiary academic center from September 2014 to October 2022. Data on pre-operative characteristics, post-operative outcomes, and total weight loss at 3 months, 6 months, and 1 year were collected using retrospective review.

Results

The mean age of patients (67% female, 53% Hispanic) in this study was 12.2 years (SD 0.9, range 11-13). At the time of surgery, the mean BMI was 49.5 kg/m2 which represented 165% of the 95th percentile. Common pre-operative comorbidities included obstructive sleep apnea (67%), dyslipidemia (53%), and insulin resistance (47%). There were no 30-day readmissions or post-operative complications. The mean length of hospital stay was 2.8 days (SD 0.5). The mean percent total body weight loss was 13.6% (SD 4.6) at 3 months, 17.7% (SD 5.2) at 6 months, and 23.8% (SD 10.9) at 1 year.

Conclusions

Bariatric surgery is a safe and effective treatment for children and adolescents with obesity, even as young as 11 years old. We demonstrated favorable post-operative outcomes, with durable weight loss at 1 year post-operatively.