Metabolic and bariatric surgery for obesity in Prader Willi syndrome: systematic review and meta-analysis

• Published in: Surgery for obesity and related diseases Vol. 19; no. 8; pp. 907 - 915
• Main Authors: Wolfe, Gunnar, Salehi, Vesta, Browne, Allen, Riddle, Renee, Hall, Erin, Fam, John, Tichansky, David, Myers, Stephan
• Format: Journal Article
• Language: English
• Published: United States 01-08-2023
• Subjects: Bariatric Surgery; Biliopancreatic Diversion; Gastric Bypass; Humans; Obesity; Prader-Willi Syndrome - complications; Prader-Willi Syndrome - surgery; Children; Prader-Willi syndrome; Adolescents; Metabolic and bariatric surgery; Weight loss
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2023.01.017

Obesity is the leading cause of morbidity and mortality in patients with Prader-Willi Syndrome (PWS). Our objective was to compare changes in body mass index (BMI) after metabolic and bariatric surgery (MBS) for the treatment of obesity (BMI ≥35 kg/m
) in PWS. A systematic review of MBS in PWS was performed using PubMed, Embase, and Cochrane Central, identifying 254 citations. Sixty-seven patients from 22 articles met criteria for inclusion in the meta-analysis. Patients were organized into 3 groups: laparoscopic sleeve gastrectomy (LSG), gastric bypass (GB), and biliopancreatic diversion (BPD). No mortality within 1 year was reported in any of the 3 groups after a primary MBS operation. All groups experienced a significant decrease in BMI at 1 year with a mean reduction in BMI of 14.7 kg/m
(P < .001). The LSG groups (n = 26) showed significant change from baseline in years 1, 2, and 3 (P value at year 3 = .002) but did not show significance in years 5, 7, and 10. The GB group (n = 10) showed a significant reduction in BMI of 12.1 kg/m
in the first 2 years (P = .001). The BPD group (n = 28) had a significant reduction in BMI through 7 years with an average reduction of 10.7 kg/m
(P = .02) at year 7. Individuals with PWS who underwent MBS had significant BMI reduction sustained in the LSG, GB, and BPD groups for 3, 2, and 7 years, respectively. No deaths within 1 year of these primary MBS operations were reported in this study or any other publication.