Sleeve Gastrectomy in Paediatric and Transition Age Patients with Prader-Willi Syndrome: A 5-Year Longitudinal Study
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ID: 314847
2026
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Abstract
OBJECTIVE: To evaluate the long-term effectiveness of laparoscopic sleeve gastrectomy (LSG) in paediatric and transition-age patients with Prader-Willi syndrome (PWS). DESIGN: Single-centre, longitudinal, retrospective cohort study. METHODS: We reviewed EHRs of 110 patients with PWS and 268 subjects undergoing LSG. We included 16 patients with PWS and severe obesity (PWS-LSG) and 32 matched non-syndromic patients with obesity (OB-LSG), both undergoing LSG, and 16 patients with PWS receiving lifestyle intervention only (PWS-LS). The primary endpoint was ΔBMI-SDS% at 5 years. RESULTS: In PWS-LSG, BMI-SDS decreased from 5.18 to an early nadir at 1-2 years (median ΔBMI-SDS% ∼-26%), then partially rebounded to 4.75 at 5 years, with ΔBMI-SDS% -16.9% (p= 0.012). Conventional metrics confirmed this attenuated response, with %BMI change -2.8% and absolute ΔBMI-SDS -1.10 at 5 years. In OB-LSG, BMI-SDS declined from 4.95 to 2.24, with larger and more sustained improvement (ΔBMI-SDS% -57.4%; p<0.001 within-group; p=0.002 vs PWS-LSG), corresponding to a %BMI change -40.1% and absolute ΔBMI-SDS -2.81 at 5 years. In PWS-LS, BMI-SDS increased from 2.25 to 3.19 (ΔBMI-SDS% +36.4%, p=0.003). The mean number of obesity-related comorbidities decreased in PWS-LSG (2.69±1.66 to 1.94±1.18; p=0.041) and in OB-LSG (1.25±0.88 to 0.56±0.76; p<0.001), but increased in PWS-LS (1.56±0.96 to 2.44±1.32; p=0.004). CONCLUSION: In PWS, LSG produces clinically relevant early weight loss with partial maintenance at 5 years, but markedly attenuated long-term benefit compared with non-syndromic peers. Nevertheless, when interpreted against the progressive worsening of obesity and cardiometabolic comorbidities observed with lifestyle intervention alone, LSG appears to modify disease trajectory in PWS.
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| Authors | Alessia Aureli, Francesco Carlomagno, Antonino Crinò, Sarah Bocchini, Sonia Battaglia, Daniela Camanni, Emanuela Ceriati, Michela Mariani, Stefano Delli Noci, Melania Manco, Francesco De Peppo, Andrea M. Isidori, Stefano Cianfarani, Danilo Fintini |
| Journal | the journal of clinical endocrinology & metabolism |
| Year | 2026 |
| DOI |
10.1210/clinem/dgag210
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| URL | |
| Keywords | Keywords not found |
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