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  • Title: Long-term outcome after laparoscopic sleeve gastrectomy in patients over 65 years old: a retrospective analysis.
    Author: Garofalo F, Denis R, Pescarus R, Atlas H, Bacon SL, Garneau P.
    Journal: Surg Obes Relat Dis; 2017 Jan; 13(1):1-6. PubMed ID: 27516222.
    Abstract:
    BACKGROUND: Bariatric surgery has been proven to be a safe and effective treatment for obesity with BMI (body mass index) reduction, and resolution or lowering of obesity-related co-morbidities. The relative age limit for bariatric surgery has gradually been increased to 60 years of age and above. OBJECTIVES: The aim of this study was to assess the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) performed in older patients (≥65 years old). SETTING: University hospital. METHODS: Between May 1, 2007 and November 30, 2013, 30 consecutive patients≥65 years old were included in this retrospective study of our prospectively collected bariatric database. RESULTS: A total of 27 (90%) primary LSG and 3 revisional LSG (10%) were performed. Mean patient age was 67.2 (range: 65-74) years, and mean preoperative BMI (±standard deviation [SD]) was 44.1±5.6 kg/m2. Thirty-day morbidity included 3 cases of self-limiting nausea and vomiting and 1 case of gastric sleeve stenosis necessitating conversion to gastric bypass. No mortality reported. The overall mean percentage of excess weight loss (±SD) and percentage of total weight loss (±SD) at 12 months were 53.8±19.8 and 23.9±8.4; 52.9±21.8 and 24±9.9 at 36 months, respectively. No patients were lost to follow-up but 5 were excluded because they underwent revisions. Age-adjusted mixed model analyses revealed that baseline BMI (P = .018), BMI>45 kg/m2 (P = .001), and having diabetes (P = .030) were associated with excess weight loss<50% across follow-up. CONCLUSION: LSG seems to be effective and safe for patients≥65 years old. Obesity related co-morbidities have improved across follow-up. BMI>45 kg/m2 and diabetes is associated with insufficient weight loss or weight regain.
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