Reply to commentary "Laparoscopic gastric plication in morbidly obese adolescents: a prospective study"

Background: The prevalence of obesity has increased rapidly among adolescents. Bariatric surgery is associated with significant weight loss and improvement in obesity related co-morbidities, but may be associated with serious complications. Therefore, attempts on finding a safe and effective bariatric procedure for adolescents are ongoing. The objective of this study was to evaluate safety and efficacy of laparoscopic gastric plication (LOP) on adolescents. Method: A prospective study was performed on adolescents who underwent LOP from 2007 2013. Measured parameters included the percentage of excess weight (%EWL), percentage of body mass index loss (%BMIL), obesity related co-morbidities, operative time, and length of hospitalization and complications. Results: LOP was performed in 12 adolescents (9 female and 3 male). Mean (SD) age of the patients was 13.8 +/- 1 year. Mean preoperative weight and BMI were 112.4 +/- 19.7 kg and 46.0 +/- 4 kg/m(2), respectively. Mean (SD) %EWL and %EBMIL were 68.2 +/- 9.9% and 79.0 +/- 9.0%, respectively after 2 years. All medical co-morbidities were improved after LOP. There were no deaths. One patient required replication 4 days postoperatively due to obstruction at the site of the last knot. No other major complications were observed. No patient required rehospitalization. Conclusion: LGP has the potential of being an ideal weight loss surgery for adolescents, resulting in excellent weight loss and minimal psychological disruption. It is associated with a minimal risk of leakage, bleeding, and nutritional deficiency. However, large well-designed studies with long-term follow-up are needed. (C) 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.