Clinics (Sao Paulo, Brazil) · 2026
Safety and efficacy of laparoscopic sleeve gastrectomy in adolescents with Grade V obesity (BMI ≥ 50 kg/m2).
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Guo Haobing, Wang Guiqi, Zhang Jian, Pang Liyun, Gu Jingfeng
Аннотация
OBJECTIVE: To investigate the effects of Laparoscopic Sleeve Gastrectomy (LSG) on the safety profile and metabolic parameter improvement in adolescents (10‒17 years-old) with grade IV obesity (BMI ≥ 50 kg/m2).
METHODS: From May 2023 to September 2024, a total of 60 adolescent patients with grade IV obesity who underwent LSG at the Department of Bariatric and Metabolic Diseases, The First Hospital of Hebei Medical University, were enrolled as the initial study cohort. Observations and statistics were collected on surgical-related complications, body weight, (Body Mass Index) BMI, glucose metabolism indicators, lipid metabolism indicators, liver function, and nutritional status to analyze the safety and efficacy of the procedure.
RESULTS: A total of 60 adolescent patients successfully underwent LSG without conversion to open surgery or perioperative mortality. During postoperative follow-up, only 31 patients completed regular assessments with complete data available for analysis. There were no perioperative period complications such as postoperative hemorrhage or gastric leak. Follow-up assessments at 3-months, 6-months, and 1-year postoperatively revealed significant improvements (p < 0.05) in the following parameters: body weight .[preoperative (154.1 ± 19.3) kg, 1-year postoperative (97.8 ± 13.6) kg], BMI .[preoperative (51.9 ± 3.8) kg/m2, 1-year postoperative (30.2 ± 1.4) kg/m2], uric acid .[preoperative (491.5 ± 92.4) μmoL/L, 1-year postoperative (376.8 ± 23.6) μmoL/L], liver function, blood lipids, glycated hemoglobin, and fasting insulin .[preoperative (57.9 ± 17.6) μIU/L, 1-year postoperative (15.5 ± 6.2) μIU/L] Preoperatively, 12 patients had hypertension, 8 had type 2 diabetes mellitus, 4 had Polycystic Ovary Syndrome (PCOS), and 10 had Non-Alcoholic Fatty Liver Disease (NAFLD). At 1-year after surgery, all patients with hypertension and type 2 diabetes mellitus achieved remission criteria. In addition, imaging findings and liver function improved significantly in 7 of the 10 patients with fatty liver disease, and clinical manifestations improved in 3 of the 4 patients with polycystic ovary syndrome. Concurrently, a declining trend (p < 0.05) was observed postoperatively in hemoglobin, trace elements (calcium, iron), and vitamins (Vitamin D, Vitamin B12), although all values remained within the normal range.
CONCLUSION: LSG is a safe and effective procedure for improving metabolic disorders in adolescent patients with grade IV obesity, with confirmed short-term efficacy. However, the widespread declining trend in postoperative nutritional indicators underscores that systematic nutritional monitoring and intervention must be a core component of postoperative management in clinical practice to achieve long-term health benefits.
METHODS: From May 2023 to September 2024, a total of 60 adolescent patients with grade IV obesity who underwent LSG at the Department of Bariatric and Metabolic Diseases, The First Hospital of Hebei Medical University, were enrolled as the initial study cohort. Observations and statistics were collected on surgical-related complications, body weight, (Body Mass Index) BMI, glucose metabolism indicators, lipid metabolism indicators, liver function, and nutritional status to analyze the safety and efficacy of the procedure.
RESULTS: A total of 60 adolescent patients successfully underwent LSG without conversion to open surgery or perioperative mortality. During postoperative follow-up, only 31 patients completed regular assessments with complete data available for analysis. There were no perioperative period complications such as postoperative hemorrhage or gastric leak. Follow-up assessments at 3-months, 6-months, and 1-year postoperatively revealed significant improvements (p < 0.05) in the following parameters: body weight .[preoperative (154.1 ± 19.3) kg, 1-year postoperative (97.8 ± 13.6) kg], BMI .[preoperative (51.9 ± 3.8) kg/m2, 1-year postoperative (30.2 ± 1.4) kg/m2], uric acid .[preoperative (491.5 ± 92.4) μmoL/L, 1-year postoperative (376.8 ± 23.6) μmoL/L], liver function, blood lipids, glycated hemoglobin, and fasting insulin .[preoperative (57.9 ± 17.6) μIU/L, 1-year postoperative (15.5 ± 6.2) μIU/L] Preoperatively, 12 patients had hypertension, 8 had type 2 diabetes mellitus, 4 had Polycystic Ovary Syndrome (PCOS), and 10 had Non-Alcoholic Fatty Liver Disease (NAFLD). At 1-year after surgery, all patients with hypertension and type 2 diabetes mellitus achieved remission criteria. In addition, imaging findings and liver function improved significantly in 7 of the 10 patients with fatty liver disease, and clinical manifestations improved in 3 of the 4 patients with polycystic ovary syndrome. Concurrently, a declining trend (p < 0.05) was observed postoperatively in hemoglobin, trace elements (calcium, iron), and vitamins (Vitamin D, Vitamin B12), although all values remained within the normal range.
CONCLUSION: LSG is a safe and effective procedure for improving metabolic disorders in adolescent patients with grade IV obesity, with confirmed short-term efficacy. However, the widespread declining trend in postoperative nutritional indicators underscores that systematic nutritional monitoring and intervention must be a core component of postoperative management in clinical practice to achieve long-term health benefits.