Title: Trans-Oral Vertical Gastroplasty As a Viable Treatment for Childhood Obesity - A Study of 21 Adolescents with Up to 18 Months of Follow-Up
Abstract: Introduction: Pediatric obesity has seen a dramatic increase over the last three decades. According to the US Center for Disease Control, almost one in seven adolescents are above the 95th percentile for Body Mass Index (BMI). In addition to the obesity-related metabolic risks, children in particular are subjected to psychological and social health concerns as a result of their excess weight. Furthermore, it is estimated that obese school-aged children are up to 6.5 times more likely to carry their disease into adulthood than their non-obese counterparts. Bariatric surgery for pediatric obesity has been met with controversy due to its morbidity and irreversibility. However, trans-oral techniques, such as endoluminal suturing, may offer the pediatric obese population a minimally invasive and potentially reversible procedure without the risk of surgery. METHOD: Twenty one adolescent subjects (ages 13-17) with an average baseline BMI of 36.2 underwent an Endoluminal Vertical Gastroplasty (EVG) Fogel procedure. The patients (18 female / 3 male) had pre-procedure weights between 80 - 157 kgs. Through the use of trans-oral suturing, the EVG procedure apposes the anterior and posterior gastric walls to reduce the volume or capacity of the stomach in order to induce weight loss. The procedure is performed under general anesthesia and the subjects are discharged approximately 3 hours after recovery. Patients returned to the office for follow-up visits at 1, 3, 6, 12, and 18 moths post procedure. Results: No adverse events or serious complications occurred during any of the procedures. The procedure duration was approximately 40 minutes. All patients lost weight and showed a significant reduction in their BMI. For those patients who have completed 18 months of follow-up (n=8; cohort's baseline BMI: 38.4), subjects realized a percent excess weight loss (%EWL) of 61.5% ± 15.8% and 58.8% ± 17.5% at 6 and 18 months respectively. For those patients who have completed 12 months of follow-up (n=15; cohort's baseline BMI: 36.8), subjects realized a %EWL of 67.3% ± 15.6% and 63.8% ± 16.7% at 6 and 12 months respectively. Conclusion: The Endoluminal Vertical Gastroplasty procedure via trans-oral suturing continues to demonstrate significant weight reduction in this obese adolescent population at one year post procedure and beyond. While further studies need to be conducted to determine the procedure's efficacy, the EVG represents a viable option for treating childhood obesity.
Publication Year: 2009
Publication Date: 2009-04-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 4
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