Laparoscopic Sleeve Gastrectomy in Children Younger Than 14 Years Refuting the Concerns

Objective:To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on growth in children younger than 14 years in a matched control study.Background:Debatable concerns result in denying young children access to bariatric surgery.Methods:Our multidisciplinary program database was used to extract data of young nonsyndromic children (age 14 years) who underwent LSG. Patients were age, sex, and height z-score matched with those on nonsurgical weight management, and their results were compared with those of older adolescents (age > 14 years) who underwent LSG. Generalized estimating equation analysis was done to assess growth.Results:One hundred sixteen children younger than 14 years (meanSD, 11.2 +/- 2.5 years) underwent LSG. Compared with the 1:1 matched group of nonsurgical weight management, these children experienced significantly higher growth, gaining 0.9mm more per month on average. Compared with 158 adolescents (age, 17.3 +/- 2.0 years) who underwent LSG in our institution, children younger than 14 years had a significantly lower prevalence of comorbidities (P<0.001) but similar resolution rates (P=0.72-0.99). There was no significant difference in the rate of complications (P=0.77), and no mortality or significant morbidity was observed in any of the groups.Conclusions:This study challenges existing concerns regarding the safety and efficacy of bariatric surgery in prepubertal children. LSG is evidently safe and effective in this age group, resulting in significant weight loss, improved growth, and resolution of comorbidities without mortality or significant morbidity.