PEDIATRC WEIGHT LOSS SURGERY PATIENTS VARY BY PROCEDURE: - PowerPoint PPT Presentation

PEDIATRC WEIGHT LOSS SURGERY PATIENTS VARY BY PROCEDURE: PREOPERATIVE CHARACTERISTICS OF 402 ADOLESCENTS WITH MORBID OBESITY DANIELLE TAMBURRINI DO, GUS SLOTMAN MD INSPIRA HEALTH NETWORK, DEPARTMENT OF SURGERY VINELAND, NJ

DANIELLE TAMBURRINI GUS SLOTMAN

METHODS • 402 adolescents • Retrospective chart review of BOLD Database • Surgical procedures compared: ABG (adjustable gastric banding), LRYGB (laparoscopic Roux-en-Y gastric bypass, and SLEEVE (vertical sleeve gastrectomy) • Clinical factors examined: demographics, age, weight, BMI, Type II diabetes, hypertension, dyslipidemia, GERD, asthma, obstructive sleep apnea, obesity hypoventilation syndrome, impaired ambulation, back pain, depression, and alcohol/tobacco use. • Statistical analysis: continuous variables ANOVA, categorical variables general linear model

RESULTS FEMALE n = 301 RANGE 6-18 YEARS MALE n = 101 MEDIAN 17 YEARS AGB LRYBG SLEEVE BPD W/ DS OTHER 38% 35% 25% 0.5% 1.5% CAUCASIAN HISPANIC AFRICAN AMERICAN ASIAN NA/ALASKAN/HAWAIIAN OTHER 56% 13% 9% 1% 1.5% 19% USA ROMANIA UNITED ARAB EMRIATES SAUDI ARABIA INDIA QATAR 85% 7% 3.5% 3% 1% 0.5% PRIVATE/GOVERNMENT SELF-PAY MEDICAID MEDICARE CHARITY UNKNOWN 49% 33% 6% 1% 0.5% 10%

AGB LRYGB SLEEVE p value FEMALE 79% 77% 67% <0.05 WEIGHT (lbs) 274 +/- 57 311 +/- 79 154 +/- 128 <0.001 BMI 45 +/- 7 50 +/- 10 45 +/- 10 <0.001 AGB : adjustable gastric PRIVATE INSURANCE 84% 74% 90% <0.05 banding CAUCASIAN 74% 55% 27% <0.001 LRYGB : laparoscopic Roux- USA 99% 99% 45% <0.0001 en-Y gastric bypass SLEEVE : vertical sleeve HTN 39% 42% 68% <0.0001 gastrectomy BACK PAIN 72% 66% 86% <0.0001 MEDICATED BACK PAIN 11% 19% 3% <0.05 OSA 81% 66% 81% <0.01 CPAP 6% 18% 5% <0.01 MEDICATED ASTHMA 8% 20% 12% <0.05 TOBACCO USE 2% 2% 9% <0.05 Age, depression, impaired ambulation, type II diabetes, GERD, dyslipidemia, OHS, non-medicated asthma and alcohol use did not vary by procedure.

CONCLUSIONS • Late adolescence is the dominant age for pediatric bariatric operations. • From June 2001 to February 2018 AGB was the most common pediatric bariatric procedure. • Rationales for operation choice and whether or not preoperative clinical variation by procedure influences outcomes is not clear from the data and will require further BOLD analysis.

QUESTIONS