Outcomes of bariatric surgery in adolescents: comparing high volume adult bariatric and pediatric general surgery hospitals.

PURPOSE: With the increasing prevalence of bariatric surgery in adolescents, it remains unclear whether centers specializing in pediatric general surgery or adult bariatric surgery are better equipped to perform these procedures. This study aimed to compare outcomes following pediatric bariatric surgery based on surgical volume. METHODS: Using the Nationwide Readmissions Database for 2016-2018, all patients aged 10-19 years undergoing bariatric surgery were identified. High-volume hospitals, defined as those in the highest quartile of procedures per year, were analyzed. Outcomes included conversion to open surgery, prolonged length of stay (LOS) and hospital readmission. RESULTS: Among 4,385 eligible patients, 44.5% underwent surgery in high-volume hospitals. The rate of conversion to open surgery was 0.7%, with high-volume hospitals associated with decreased risk (OR 0.42 [0.18-0.96], p=0.04). Prolonged LOS occurred in 10.1% of patients, less likely at high-volume hospitals (OR 0.63 [0.51-0.78], p<0.001). Readmission rate was 3.1%, with similar rates in high-volume hospitals (2.9%, p=0.5). CONCLUSION: Hospitals performing the highest volumes of bariatric and pediatric general surgeries demonstrated superior outcomes, despite accounting for less than half of the procedures analyzed. Accounting for hospital volumes of pediatric general and bariatric surgeries is crucial for enhancing patient outcomes.