Severely Obese Adolescents Benefit From Bariatric Surgery

2009 ◽  
Vol 42 (15) ◽  
pp. 22
Author(s):  
DAMIAN MCNAMARA
2014 ◽  
Vol 99 (10) ◽  
pp. 894-898 ◽  
Author(s):  
P. Sachdev ◽  
T. Makaya ◽  
S. S. Marven ◽  
R. Ackroyd ◽  
J. K. Wales ◽  
...  

2017 ◽  
Vol 91 (2) ◽  
pp. 451-458 ◽  
Author(s):  
Edward J. Nehus ◽  
Jane C. Khoury ◽  
Thomas H. Inge ◽  
Nianzhou Xiao ◽  
Todd M. Jenkins ◽  
...  

2020 ◽  
Vol 30 (01) ◽  
pp. 117-121
Author(s):  
Yvonne G. M. Roebroek ◽  
Suzanne R. Pruijssers ◽  
Nicole D. Bouvy ◽  
Ernest L. W. E. van Heurn

Abstract Introduction Bariatric surgery is performed at increasing rate in severely obese adolescents who do not respond to conservative treatment. In the United States, this treatment is generally accepted, yet in Europe, surgeons are more reluctant because of concerns regarding safety and (long-term) efficacy. We evaluated in which (European) countries bariatric surgery is allowed and performed, and the opinion of the members of the European Paediatric Surgeons' Association (EUPSA) regarding bariatric surgery in adolescents. Materials and Methods Information was obtained with an online questionnaire sent to all EUPSA members. Results A total of 108 pediatric surgeons (PSs) from 33 countries (of which 25 European) completed the survey. Sixty-two PSs (57.4%) from 22 countries stated that bariatric surgery in adolescents was allowed in their country. In only 14 countries, the costs were (partially) covered by health care insurances. Overall, 65.7% of the surgeons (n = 71) believed bariatric surgery may offer a valuable contribution to obtain substantial long-term weight loss in severely obese adolescents. Fifty-one (47.2%) reported that these procedures should be performed by a combination of a bariatric and a PS, while 20 (18.5%) and 16 (14.8%) preferred that these procedures should be performed solely by a PS or bariatric surgeon, respectively. Conclusion Although allowed in most European countries, bariatric surgery in adolescents is only practiced on a small scale, and the treatment is often excluded from regular health care reimbursement. The majority of PSs acknowledge the value of bariatric surgery, which should be performed by a combination of PS and bariatric surgeon.


2019 ◽  
Vol 87 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Lauren A. Sarno ◽  
Steven E. Lipshultz ◽  
Carroll Harmon ◽  
Nestor F. De La Cruz-Munoz ◽  
Preetha L. Balakrishnan

2019 ◽  
Vol 104 (6) ◽  
pp. e65.3-e66 ◽  
Author(s):  
V Ziesenitz ◽  
J Vaughns ◽  
E Williams ◽  
E Nadler ◽  
G Mikus ◽  
...  

BackgroundSevere obesity predisposes adults and youth to a higher risk of venous thromboembolism (VTE). Enoxaparin is frequently used for their VTE management. This study evaluates a BMI-stratified prophylactic dosing regimen of enoxaparin in severely obese adolescents undergoing bariatric surgery.MethodsThis prospective study enrolled severely obese adolescents aged 12–20 years undergoing laparoscopic sleeve gastrectomy. Prophylactic enoxaparin was dosed at 40 mg SC (for a BMI less than 50 kg/m2) and 60 mg SC (for a BMI equal to or greater than or 50 kg/m2). Blood samples were drawn until 12 hrs post-dose. Plasma Anti-Factor Xa (Anti-FXa) activity was used as a surrogate marker for enoxaparin plasma concentration and pharmacokinetics were assessed using non-compartmental PK analysis. The primary efficacy outcome was the anti-FXa activity 4–6 hours after dosing, and the primary endpoint was the proportion of patients who reached prophylactic anti-FXa activity of 0.1–0.3 U/mL between 4–6 hours after dosing.ResultsTen female and two male obese adolescents (age range 14–19 years) had a mean body weight of 140.8 kg (93.7–174 kg) and a mean BMI of 49.9 kg/m2 (38.4–58 kg/m2). Four patients received 40 mg enoxaparin, 8 patients were dosed with 60 mg enoxaparin. No VTE or major bleeding occurred. Peak plasma anti-FXa activity (Cmax) ranged from 0.14–0.30 IU/mL (median Cmax 0.205 IU/mL). Median Tmax was 5.67 hours (range 3.78–7.52 hours). Median AUCi was 1.00 h*IU/mL (range 0.42–1.67 h*IU/mL). 10 out of 12 patients (83%) reached the primary endpoint with anti-FXa activity in the range for VTE prevention (0.1–0.3 IU/mL).ConclusionsIn this single center cohort study, the dosing scheme of 40 mg vs 60 mg enoxaparin stratified according to BMI proved to be effective in reaching prophylactic anti-FXa activity in 83% of adolescent patients. This dosing scheme is in accordance with current practice in adults.Disclosure(s)J. Vaughns and J. van den Anker are supported by the Eunice Kennedy Shriver National Institute of Child Health and Development (5T32HD087969).


Obesity ◽  
2014 ◽  
Vol 22 (11) ◽  
pp. 2319-2325 ◽  
Author(s):  
Nianzhou Xiao ◽  
Todd M. Jenkins ◽  
Edward Nehus ◽  
Thomas H. Inge ◽  
Marc P. Michalsky ◽  
...  

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