Long-Term Follow-Up of Morbidly Obese Patients with Childhood Craniopharyngioma after Laparoscopic Adjustable Gastric Banding (LAGB)

Introduction

Craniopharyngiomas are embryogenic malformations which arise from remnants of Rathke′s pouch and affect hypothalamic and pituitary regions, both of importance in endocrine regulation and satiety modulation (Müller HL, Nat Rev Endocr, 2010; 6: 609–618). Craniopharyngiomas are the most common intracranial tumors of non-glial origin in the paediatric population. Although the tumor itself is of low histological grade of malignancy and the overall survival rate of patients is high, there is considerable morbidity. Patients often suffer from obesity and eating disorders due to hypothalamic damage. Deficient modulation of satiety and addiction to sweet foods are frequent features of the hypothalamic syndrome. Conventional strategies for weight control are less efficient because of impaired physical activity due to attendant neurological and visual deficits. Morbid obesity has major impact on quality of life in patients with craniopharyngioma (Müller HL, J Clin Endocr Metab, 2011; 96: 1981–1991).

Due to unsuccessful treatment efforts in weight control, we decided to perform adjustable LAGB in 4 patients with childhood craniopharyngioma and morbid obesity. Short-term effects on weight development after LAGB and tolerability were promising in these patients (Müller HL et al., Klin Padiatr, 2007; 218: 1–3). There are no reports in the literature on long-term effects of LAGB on weight development, tolerability and quality of life in childhood craniopharyngioma patients.