IBC Oxford University Oral Abstract 46 - Bariatric surgery for adolescent obesity: what is the current evidence?

Abstract Objectives In this systematic review and meta-analysis, we aimed to assess the impact of bariatric surgical procedures on weight reduction in adolescents. Laparoscopic sleeve gastrectomy (LSG), laparoscopic adjustable gastric band (LAGB), and laparoscopic Roux-en-Y gastric bypass (LRYGB) were evaluated, along with their associated complications. Methods We conducted a systematic review following PRISMA and Cochrane Handbook guidelines, searching databases from inception to May 12, 2023. Inclusion criteria comprised studies in the English language investigating the effects of bariatric surgery on weight loss, reporting BMI outcomes, and involving human adolescents. The quality assessment used the Newcastle-Ottawa Scale and the National Institutes of Health tool, and the meta-analysis was conducted using Stata software. Results From 1,826 initial studies, 56 met our inclusion criteria, and 45 were included in the meta-analysis. LSG and LAGB showed significant body mass index (BMI) reductions up to the 60th postoperative week (LSG: −10.008, P = 0.002; LAGB: −9.684, P = 0.003). Also, LRYGB demonstrated a significant and sustained BMI reduction, notably at 24th postoperative weeks (−18.076, P < 0.001) and 36th postoperative weeks (−18.145, P < 0.001). Minimal complications were reported after LRYGB and LAGB. However, LSG was associated with a 1% incidence of hernia (Relative Risk (RR) = 0.01, P = 0.001), an 11% occurrence of cholecystectomy (RR = 1.1, P = 0.01), and a 10% leak incidence (RR = 1.01, P = 0.01). Conclusion This systematic review and meta-analysis highlights the efficacy of bariatric surgery in reducing BMI among adolescents. LSG, LAGB, and LRYGB all yielded significant and sustained BMI reductions. While complications were generally low, LSG exhibited specific risks, emphasizing the importance of individualized patient assessment.