Clinical Report: Evolution of Adolescent Bariatric Surgery from 1980 to Present

Overview

This bibliometric review analyzes 45 years of scientific literature on metabolic and bariatric surgery (MBS) in adolescents, highlighting publication trends, key research themes, and collaboration networks. The study identifies increasing academic output, evolving surgical techniques, and persistent gaps in long-term outcomes and equitable access.

Background

Adolescent obesity is a growing global health concern linked to severe metabolic and cardiovascular comorbidities. Lifestyle interventions often fail in severe cases, prompting consideration of MBS as an effective alternative for weight loss and metabolic improvement. Despite evidence supporting safety and efficacy, MBS remains underutilized in adolescents, with disparities in access and limited long-term data guiding clinical practice.

Data Highlights

A comprehensive search across Web of Science, Scopus, and PubMed identified 2,174 relevant publications on adolescent MBS after screening 2,678 records and removing duplicates. The literature shows a steady increase in publications over time, with key contributions from specific countries, institutions, and authors. The review also maps collaboration networks and thematic focuses within the field.

Key Findings

• Adolescent MBS publications have increased significantly over the past four decades, reflecting growing scientific interest.
• Sleeve gastrectomy and Roux-en-Y gastric bypass are the predominant surgical techniques studied, with emerging robotic approaches.
• Most research originates from a limited number of countries and institutions, indicating concentrated expertise and collaboration.
• Despite demonstrated safety and efficacy, MBS is applied to a small subset of eligible adolescents, with notable disparities by ethnicity and socioeconomic status.
• Current literature lacks standardized surgical indications, long-term outcome data, and comprehensive psychosocial and ethical analyses specific to adolescents.
• Multidisciplinary care, including mental health monitoring and family support, is essential for sustained postoperative success.

Clinical Implications

Clinicians should consider MBS as a viable treatment for severe adolescent obesity, especially when lifestyle interventions fail. Careful patient selection, multidisciplinary management, and long-term follow-up are critical to optimize outcomes and address psychosocial needs. Awareness of access disparities is important to ensure equitable care delivery.

Conclusion

The scientific landscape of adolescent bariatric surgery has expanded considerably, yet significant gaps remain in evidence guiding clinical practice. Future research should focus on long-term outcomes, standardized protocols, and addressing access inequalities to improve care for this vulnerable population.

References

1. Various Authors/Multiple Years -- The Progression of Surgical Approaches to Adolescent Obesity: A Review of the Scientific Landscape from 1980 to Today