The number of adolescents undergoing bariatric surgery for weight loss more than tripled between 2000 and 2003, but bariatric surgery in adolescents remains an uncommonly performed procedure, and teens represent less than 1 percent of patients having such procedures, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Most obese teens are still treated through diet and behavioral methods, according to background information in the article. However, bariatric or weight-loss surgery is increasingly considered an option for teens who have health problems related to their weight. A common type of bariatric surgery is gastric bypass, which involves sectioning off a small portion of the stomach into a pouch that that bypasses the first part of the small intestine and connects directly to the lower portions. Another common option is gastric banding, in which surgeons place a band-like device around the stomach to divide it into two smaller compartments.
Wilson S. Tsai, M.D., Robert Wood Johnson Medical School, New Brunswick, New Jersey, and colleagues used data from a nationwide sample of community hospitals to determine the annual rate of bariatric surgery among adolescents (age 10 to 19) and adults (age 20 and older) between 1996 and 2003. Each patient's age, sex, length of hospital stay and charges from the hospital, as well as whether or not he or she died in the hospital, was also available from the same database.
During those years, 566 bariatric surgeries were performed on adolescents at the sample hospitals. This represents a national estimate of 2,744 adolescents undergoing such procedures, the researchers note. The rate of bariatric surgeries among adolescents did not change significantly between 1996 and 2000 but more than tripled between 2000 and 2003. Still, however, only 771 teens underwent the procedure in 2003--representing less than .7 percent of the 105,473 bariatric procedures performed that year.
Complication rates were similar for adolescents and adults. Respiratory complications were the most common, affecting 84.4 percent of adolescents and 67.5 percent of adults. On average, teens spent less time in the hospital after bariatric surgery (3.2 days vs. 3.5 days). No adolescents and .2 percent of adults died in the hospital in 2003. "Similar to adults, most adolescents underwent gastric bypass, had private insurance and underwent surgery at similar hospital types," the authors write. "In contrast to adults, adolescents were less likely to be female and had fewer major comorbid conditions," or co-occurring health problems.
"In conclusion, while relatively few bariatric procedures were performed in adolescents in the last decade, this study suggests that there has been a dramatic increase in the number of bariatric procedures in adolescents nationwide in the current decade," they continue. "Because the long-term metabolic and psychological consequences of bariatric surgery may differ between adolescents and adults, this trend toward greater use of bariatric surgery in teenagers emphasizes the importance of rigorous outcomes research in this area."
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