Background: The severely obese under 21 years of age are at high risk
of missing normal development during a crucial period of life and shou
ld be considered for surgical treatment. Vertical banded gastroplasty
allows patients to be treated effectively while continuing to have nor
mal digestion and absorption without the risks of complex operations.
Methods: This was a retrospective outcome review of 47 severely obese
who were under age 21 when surgically treated with VBG. Results: There
were no operative mortalities, leaks, or wound infections. Body mass
index in 25 patients followed 5 years decreased from an average operat
ive 48.1 to 36.2 kg m-2. Equally for 14 patients followed 10 years, BM
I decreased from an average operative 49.6 to 39.2 kgm-2. Both patient
groups had 74% follow-up. Conclusions: Sustained weight reduction imp
roved general health and allowed participation in life activities that
would otherwise not have been possible. Adherence to recommended oper
ative technique and intraoperative measurement of pouch volume is nece
ssary to avoid excessive enlargement of the pouch, with resulting weig
ht gain, reflux, and need for revision.