Four-Year Outcomes of One-Anastomosis Gastric Bypass in Children and Adolescents with Obesity: Safety, Effectiveness, and Resolution of Obesity-Related Medical Conditions.

BACKGROUND

Very few studies examined the safety and effectiveness of OAGB among adolescents. We undertook this task.

METHODS

Retrospective review of consecutive adolescents (N = 91, 11-21 years old) who underwent primary OAGB in Lebanon and Egypt (January 2013-January 2018). Data retrieved included anthropometric variables (weight, BMI, EWL%, TWL%), nutritional/metabolic outcomes (hemoglobin, protein, vitamin B12, albumin, Ca, HbA1c), and obesity-related conditions (T2DM, hypertension, depression, PCOS, OSA, and GERD). Data were retrieved preoperatively and at 1, 2, 3, and 4 years.

RESULTS

Mean age was 16.6 years, weight 117.6 kg, BMI 42 kg/m, and 81.3% were females. By year 1, weight loss was large and significant, maintained through subsequent years (mean weight = 74.3 kg), mirrored by significant BMI reductions (mean BMI28.9 kg/m). At year 1, mean EWL% was 80.2 ± 18.6% and TWL% 31.2 ± 5.8%, reaching 35.48 ± 8.85% and 91.26 ± 21.85% at year 4. At year four, HbA1c levels significantly decreased from preoperative 5.82 to 5.02%. Mean Hb, vitamin B12, albumin, protein, and calcium levels were significantly reduced from baseline to year 4, although the reduced levels remained within the normal reference ranges. All T2DM, PCOS, and hypertension cases achieved remission at year 1, maintained thereafter, with very few recurrences. OSA showed 83.3% resolution by year 1, with the rest achieving resolution at year 2. GERD was halved by year 1 and maintained. Complications were low (2.2%), with no mortality.

CONCLUSION

OAGB is a safe and effective long-term procedure for adolescents. Weight loss and BMI reduction were significant, and remissions of obesity-related conditions were achieved and maintained. Larger studies are required.