Background

Severe pediatric obesity has grown exponentially and affects 4.5 million children in the US. Metabolic/Bariatric Surgery (MBS) in the pediatric population is a safe, effective treatment. Trends and outcomes in adult MBS are well defined. In this study we identify trends and outcomes in pediatric bariatric surgery.

Methods

MBSAQIP 2017-2022 was the data source. Patients 11-17 years of age, who underwent primary bariatric surgery were included in the study. Primary outcome was national procedure rate. Secondary outcome analyses included procedure type, BMI, demographics, and perioperative outcomes.

Results

2517 patients fit inclusion. A gradual increase in bariatric surgery was observed despite the 2020 pandemic. Mean age was 16.3 (11-17), mean BMI 46.95 (35-73), proportion of males increased during the study period from 21.2% to 32.2%. Rate of gastric sleeve increased from 68.1% to 95.2% while gastric bypass decreased from 22.7% to 4.3%. The most dramatic change was in adjustable banding, from 5.4% to 0%. Median hospital stay was 1 day (1-4), readmission rate was 2.4%, reoperation rate was 0.3%, and no 30-day mortalities were identified.

Conclusions

In the last 7 years pediatric bariatric surgery increased despite the pandemic. Sleeve gastrectomy is the most commonly performed procedure. The use of gastric bypass decreased, gastric banding was abandoned. Despite the proven benefits and safety of MBS, it is still underutilized in the pediatric population. The reason for this is multifactorial. Societies should take on the tasks of educating referring physicians and the public and should advocate for increased access to MBS care.