Laparoscopic sleeve gastrectomy in an adolescent with Prader-Willi syndrome: psychosocial implications

ABSTRACT Prader-Willi syndrome (PWS) is a complex genetic disorder and represents the most common genetic cause of life-threatening obesity in childhood and adolescence. The indication for bariatric surgery in children and adolescents with syndromic obesity is still controversial. This case report deals with the preoperative medical and psychosocial evaluation of a 16-year old male adolescent with PWS who underwent sleeve gastrectomy (SG). Information on a 6-month follow up is also reported. The preoperative body weight was 223 kg (BMI = 80.9 kg/m2). Comorbidities included severe obstructive sleep apnea (OSA) with nocturnal respiratory failure (NRF), hypertension and impaired glucose tolerance. At 2 and 6-month follow up the percent excess weight loss (EWL%) was 16 (BMI = 71.8 kg/m2) and 29.2 (BMI = 64.6 kg/m2), respectively. Co-morbities did improve. Intellectual disability of genetic origin per se may not represent an absolute contraindication to bariatric surgery if adequate and tailored clinical and psychosocial support is provided.