Study compares adverse events after two types of bariatric surgery in adolescents

Adolescents who underwent sleeve gastrectomy, a type of weight-loss surgery that involves removing part of the stomach, were less likely to go the emergency room or be admitted to the hospital in the five years after their operations than those who had their stomachs divided into pouches through gastric bypass surgery, according to new research.

Rates of complications, death and subsequent surgery were similar in both groups, University of Michigan researchers found in an analysis published in JAMA.

All the patients studied had Medicaid, the largest health insurance provider for those under the age of 19 in the United States.

“Prior research had found that sleeve gastrectomy and gastric bypass resulted in significant weight loss and low complication rates in adolescents with severe obesity,” said Ryan Howard, M.D., a general surgery resident at University of Michigan Health. “But the comparative outcomes of these two procedures, which might help inform health insurance policy and decision-making, had yet to be explored for adolescents insured by Medicaid.”

The researchers identified just over 1,110 patients who had undergone one of the two weight-loss surgeries between 2012 and 2018, a relatively small number compared to the more than 95,000 patients covered by Medicare who had either gastric bypass or a sleeve gastrectomy in the same time period.

Howard says the disparity could be due to access issues or concerns about bariatric surgery as a weight-loss treatment for youth.

Additional authors include Jie Yang, Ph.D., and Jyothi Thumma, M.P.H., of the University of Michigan Center for Healthcare Outcomes and Policy and Anne Ehlers, M.D., M.P.H., Sean O’Neill, M.D., Ph.D., Dana Telem, M.D., M.P.H., and Justin B. Dimick, M.D., M.P.H., all of Michigan Medicine.

Paper cited: “Health Care Use and Adverse Events After Sleeve Gastrectomy and Gastric Bypass Among Adolescents With Severe Obesity Insured by Medicaid,” JAMA.