Skip to main content
Erschienen in: Obesity Surgery 12/2020

08.10.2020 | Review

Is Laparoscopic Bariatric Surgery Safe and Effective in Patients over 60 Years of Age?” an Updated Systematic Review and Meta-Analysis

verfasst von: Antoine Vallois, Benjamin Menahem, Arnaud Alves

Erschienen in: Obesity Surgery | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

To evaluate, mid-term outcomes between elderly patients (EP, i.e., age > 60 years old) and young patients (YP, i.e., age < = 60 years old) who underwent laparoscopic bariatric surgery. Studies comparing EP versus YP for bariatric surgery published until April 2020 were selected and submitted to a systematic review and meta-analysis. After LSG, overall morbidity and specific post-operative complication rates (i.e., leak, abscess, hemorrhage, and reoperation) were significantly more frequent in EP compared with those in YP. Surgical outcomes were similar between EP and YP after LRYGB. Both procedures achieved weight loss, but it was statistically greater in YP compared with that in EP. In summary, this meta-analysis suggests that laparoscopic bariatric surgery is a safe and effective treatment in EP compared with that in YP.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Mathus-Vliegen EM. Obesity and the elderly. J Clin Gastroenterol. 2012;46:533–44.PubMed Mathus-Vliegen EM. Obesity and the elderly. J Clin Gastroenterol. 2012;46:533–44.PubMed
2.
Zurück zum Zitat Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386:964–73.PubMed Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386:964–73.PubMed
3.
Zurück zum Zitat Schauer PR, Bhatt DL, Kashyap SR. Bariatric surgery or intensive medical therapy for diabetes after 5 years. N Engl J Med. 2017;376(20):1997.PubMed Schauer PR, Bhatt DL, Kashyap SR. Bariatric surgery or intensive medical therapy for diabetes after 5 years. N Engl J Med. 2017;376(20):1997.PubMed
4.
Zurück zum Zitat Sugerman HJ, DeMaria EJ, Kellum JM, et al. Effects of bariatric surgery in older patients. Ann Surg. 2004;240:243–7.PubMedPubMedCentral Sugerman HJ, DeMaria EJ, Kellum JM, et al. Effects of bariatric surgery in older patients. Ann Surg. 2004;240:243–7.PubMedPubMedCentral
5.
Zurück zum Zitat Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627–35.PubMedPubMedCentral Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627–35.PubMedPubMedCentral
6.
Zurück zum Zitat Lynch J, Belgaumkar A. Bariatric surgery is effective and safe in patients over 55: a systematic review and meta-analysis. Obes Surg. 2012;22:1507–16.PubMed Lynch J, Belgaumkar A. Bariatric surgery is effective and safe in patients over 55: a systematic review and meta-analysis. Obes Surg. 2012;22:1507–16.PubMed
7.
Zurück zum Zitat Chow A, Switzer NJ, Gill RS, et al. Roux-en-Y gastric bypass in the elderly: a systematic review. Obes Surg. 2016;26:626–30.PubMed Chow A, Switzer NJ, Gill RS, et al. Roux-en-Y gastric bypass in the elderly: a systematic review. Obes Surg. 2016;26:626–30.PubMed
8.
Zurück zum Zitat Meunier H, Le Roux Y, Fiant AL, et al. Does the implementation of enhanced recovery after surgery (ERAS) guidelines improve outcomes of bariatric surgery? A propensity score analysis in 464 patients. Obes Surg. 2019;29:2843–53.PubMed Meunier H, Le Roux Y, Fiant AL, et al. Does the implementation of enhanced recovery after surgery (ERAS) guidelines improve outcomes of bariatric surgery? A propensity score analysis in 464 patients. Obes Surg. 2019;29:2843–53.PubMed
9.
Zurück zum Zitat Mantziari S, Dayer A, Duvoisin C, et al. Long-term weight loss, metabolic outcomes, and quality of life at 10 years after Roux-en-Y gastric bypass are independent of patients’ age at baseline. Obes Surg. 2020;30:1181–8.PubMed Mantziari S, Dayer A, Duvoisin C, et al. Long-term weight loss, metabolic outcomes, and quality of life at 10 years after Roux-en-Y gastric bypass are independent of patients’ age at baseline. Obes Surg. 2020;30:1181–8.PubMed
10.
Zurück zum Zitat Marczuk P, Kubisa MJ, Święch M, et al. Effectiveness and safety of Roux-en-Y gastric bypass in elderly patients-systematic review and meta-analysis. Obes Surg. 2019;29:361–8.PubMed Marczuk P, Kubisa MJ, Święch M, et al. Effectiveness and safety of Roux-en-Y gastric bypass in elderly patients-systematic review and meta-analysis. Obes Surg. 2019;29:361–8.PubMed
11.
Zurück zum Zitat Giordano S, Salminen P. Laparoscopic sleeve gastrectomy is safe for patients over 60 years of age: a meta-analysis of comparative studies. J Laparoendosc Adv Surg Tech A. 2020;30:12–9.PubMed Giordano S, Salminen P. Laparoscopic sleeve gastrectomy is safe for patients over 60 years of age: a meta-analysis of comparative studies. J Laparoendosc Adv Surg Tech A. 2020;30:12–9.PubMed
12.
Zurück zum Zitat Xu C, Yan T, Liu H, et al. Comparative safety and effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in obese elder patients: a systematic review and meta-analysis. Obes Surg. 2020;10 Xu C, Yan T, Liu H, et al. Comparative safety and effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in obese elder patients: a systematic review and meta-analysis. Obes Surg. 2020;10
13.
Zurück zum Zitat Methley A, Campbell S, Chew-Graham C, et al. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14:579.PubMedPubMedCentral Methley A, Campbell S, Chew-Graham C, et al. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14:579.PubMedPubMedCentral
14.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedPubMedCentral
15.
Zurück zum Zitat Vallois A, Menahem B, Le Roux Y, et al. Revisional Roux-en-Y gastric bypass: a safe surgical opportunity? Results of a case-matched study. Obes Surg. 2019;29:903–10.PubMed Vallois A, Menahem B, Le Roux Y, et al. Revisional Roux-en-Y gastric bypass: a safe surgical opportunity? Results of a case-matched study. Obes Surg. 2019;29:903–10.PubMed
16.
Zurück zum Zitat Robert M, Pasquer A, Espalieu P, et al. Gastric bypass for obesity in the elderly: is it as appropriate as for young and middle-aged populations? Obes Surg. 2014;24:1662–9.PubMed Robert M, Pasquer A, Espalieu P, et al. Gastric bypass for obesity in the elderly: is it as appropriate as for young and middle-aged populations? Obes Surg. 2014;24:1662–9.PubMed
17.
Zurück zum Zitat Yoon J, Sherman J, Argiroff A, et al. Laparoscopic sleeve gastrectomy and gastric bypass for the aging population. Obes Surg. 2016;26:2611–5.PubMed Yoon J, Sherman J, Argiroff A, et al. Laparoscopic sleeve gastrectomy and gastric bypass for the aging population. Obes Surg. 2016;26:2611–5.PubMed
18.
Zurück zum Zitat Montastier E, Becouarn G, Bérard E, et al. Gastric bypass in older patients: complications, weight loss, and resolution of comorbidities at 2 years in a matched controlled study. Obes Surg. 2016;26:1806–13.PubMed Montastier E, Becouarn G, Bérard E, et al. Gastric bypass in older patients: complications, weight loss, and resolution of comorbidities at 2 years in a matched controlled study. Obes Surg. 2016;26:1806–13.PubMed
19.
Zurück zum Zitat Peter SDS, Craft RO, Tiede JL, et al. Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass. Arch Surg. 2005;140:165–8. Peter SDS, Craft RO, Tiede JL, et al. Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass. Arch Surg. 2005;140:165–8.
20.
Zurück zum Zitat Thereaux J, Poitou C, Barsamian C, et al. Midterm outcomes of gastric bypass for elderly (aged ≥ 60 yr) patients: a comparative study. Surg Obes Relat Dis. 2015;11:836–41.PubMed Thereaux J, Poitou C, Barsamian C, et al. Midterm outcomes of gastric bypass for elderly (aged ≥ 60 yr) patients: a comparative study. Surg Obes Relat Dis. 2015;11:836–41.PubMed
21.
Zurück zum Zitat Van Nieuwenhove Y, Spriet E, Sablon T, et al. Metabolic surgery in patients over 60 years old: short- and long-term results. Acta Chir Belg. 2016;116:362–6.PubMed Van Nieuwenhove Y, Spriet E, Sablon T, et al. Metabolic surgery in patients over 60 years old: short- and long-term results. Acta Chir Belg. 2016;116:362–6.PubMed
22.
Zurück zum Zitat Hassinger TE, Mehaffey JH, Johnston LE, et al. Roux-en-Y gastric bypass is safe in elderly patients: a propensity-score matched analysis. Surg Obes Relat Dis. 2018;14:1133–8.PubMedPubMedCentral Hassinger TE, Mehaffey JH, Johnston LE, et al. Roux-en-Y gastric bypass is safe in elderly patients: a propensity-score matched analysis. Surg Obes Relat Dis. 2018;14:1133–8.PubMedPubMedCentral
23.
Zurück zum Zitat Kaplan U, Penner S, Farrokhyar F, et al. Bariatric surgery in the elderly is associated with similar surgical risks and significant long-term health benefits. Obes Surg. 2018;28(8):2165–70.PubMed Kaplan U, Penner S, Farrokhyar F, et al. Bariatric surgery in the elderly is associated with similar surgical risks and significant long-term health benefits. Obes Surg. 2018;28(8):2165–70.PubMed
24.
Zurück zum Zitat Ritz P, Topart P, Benchetrit S, et al. Benefits and risks of bariatric surgery in patients aged more than 60 years. Surg Obes Relat Dis. 2014;9 Ritz P, Topart P, Benchetrit S, et al. Benefits and risks of bariatric surgery in patients aged more than 60 years. Surg Obes Relat Dis. 2014;9
25.
Zurück zum Zitat Pequignot A, Prevot F, Dhahri A, et al. Is sleeve gastrectomy still contraindicated for patients aged≥60 years? A case-matched study with 24 months of follow-up. Surg Obes Relat Dis. 2015;11:1008–13.PubMed Pequignot A, Prevot F, Dhahri A, et al. Is sleeve gastrectomy still contraindicated for patients aged≥60 years? A case-matched study with 24 months of follow-up. Surg Obes Relat Dis. 2015;11:1008–13.PubMed
26.
Zurück zum Zitat Hajer AA, Wolff S, Benedix F, et al. Trends in early morbidity and mortality after sleeve Gastrectomy in patients over 60 years : retrospective review and data analysis of the German Bariatric Surgery Registry. Obes Surg. 2018;28:1831–7.PubMed Hajer AA, Wolff S, Benedix F, et al. Trends in early morbidity and mortality after sleeve Gastrectomy in patients over 60 years : retrospective review and data analysis of the German Bariatric Surgery Registry. Obes Surg. 2018;28:1831–7.PubMed
27.
Zurück zum Zitat Mizrahi I, Alkurd A, Ghanem M, et al. Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years. Obes Surg. 2014;24:855–60.PubMed Mizrahi I, Alkurd A, Ghanem M, et al. Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years. Obes Surg. 2014;24:855–60.PubMed
28.
Zurück zum Zitat Luppi CR, Balagué C, Targarona EM, et al. Laparoscopic sleeve gastrectomy in patients over 60 years: impact of age on weight loss and co-morbidity improvement. Surg Obes Relat Dis. 2015;11:296–301.PubMed Luppi CR, Balagué C, Targarona EM, et al. Laparoscopic sleeve gastrectomy in patients over 60 years: impact of age on weight loss and co-morbidity improvement. Surg Obes Relat Dis. 2015;11:296–301.PubMed
29.
Zurück zum Zitat Navarrete A, Corcelles R, Del Gobbo GD, et al. Sleeve gastrectomy in the elderly: a case-control study with long-term follow-up of 3 years. Surg Obes Relat Dis. 2017;13:575–80.PubMed Navarrete A, Corcelles R, Del Gobbo GD, et al. Sleeve gastrectomy in the elderly: a case-control study with long-term follow-up of 3 years. Surg Obes Relat Dis. 2017;13:575–80.PubMed
30.
Zurück zum Zitat Hayashi A, Maeda Y, Takemoto M, et al. Outcomes of laparoscopic sleeve gastrectomy in elderly obese Japanese patients. Geriatr Gerontol Int. 2017;17:2068–73.PubMed Hayashi A, Maeda Y, Takemoto M, et al. Outcomes of laparoscopic sleeve gastrectomy in elderly obese Japanese patients. Geriatr Gerontol Int. 2017;17:2068–73.PubMed
31.
Zurück zum Zitat Bartosiak K, Różańska-Walędziak A, Walędziak M, et al. The safety and benefits of laparoscopic sleeve gastrectomy in elderly patients: a case-control study. Obes Surg. 2019;29:2233–7.PubMed Bartosiak K, Różańska-Walędziak A, Walędziak M, et al. The safety and benefits of laparoscopic sleeve gastrectomy in elderly patients: a case-control study. Obes Surg. 2019;29:2233–7.PubMed
32.
Zurück zum Zitat Dowgiałło-Wnukiewicz N, Janik MR, Lech P, et al. Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study. Wideochir Inne Tech Maloinwazyjne. 2020;15:123–8.PubMed Dowgiałło-Wnukiewicz N, Janik MR, Lech P, et al. Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study. Wideochir Inne Tech Maloinwazyjne. 2020;15:123–8.PubMed
33.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, et al. PRISMA Group Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther. 2009;89:873–80.PubMed Moher D, Liberati A, Tetzlaff J, et al. PRISMA Group Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys Ther. 2009;89:873–80.PubMed
34.
Zurück zum Zitat Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.PubMed Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.PubMed
35.
Zurück zum Zitat Cardoso L, Rodrigues D, Gomes L, et al. Short- and long-term mortality after bariatric surgery: a systematic review and meta-analysis. Diabetes Obes Metab. 2017;19:1223–32.PubMed Cardoso L, Rodrigues D, Gomes L, et al. Short- and long-term mortality after bariatric surgery: a systematic review and meta-analysis. Diabetes Obes Metab. 2017;19:1223–32.PubMed
36.
Zurück zum Zitat Haywood C, Sumithran P. Treatment of obesity in older persons-a systematic review. Obes Rev. 2019;20:588–98.PubMed Haywood C, Sumithran P. Treatment of obesity in older persons-a systematic review. Obes Rev. 2019;20:588–98.PubMed
37.
Zurück zum Zitat Kauppila JH, Santoni G, Tao W, et al. Reintervention or mortality within 90 days of bariatric surgery: population-based cohort study. Br J Surg. 2020 (in press);107:1221–30.PubMed Kauppila JH, Santoni G, Tao W, et al. Reintervention or mortality within 90 days of bariatric surgery: population-based cohort study. Br J Surg. 2020 (in press);107:1221–30.PubMed
38.
Zurück zum Zitat Hajer AA, Wolff S, Benedix F, et al. Trends in early morbidity and mortality after sleeve gastrectomy in patients over 60 years : retrospective review and data analysis of the German Bariatric Surgery Registry. Obes Surg. 2018;28:1831–7.PubMed Hajer AA, Wolff S, Benedix F, et al. Trends in early morbidity and mortality after sleeve gastrectomy in patients over 60 years : retrospective review and data analysis of the German Bariatric Surgery Registry. Obes Surg. 2018;28:1831–7.PubMed
39.
Zurück zum Zitat Goldberg I, Yang J, Nie L, et al. Safety of bariatric surgery in patients older than 65 years. Surg Obes Relat Dis. 2019;15:1380–7.PubMed Goldberg I, Yang J, Nie L, et al. Safety of bariatric surgery in patients older than 65 years. Surg Obes Relat Dis. 2019;15:1380–7.PubMed
40.
Zurück zum Zitat Janik MR, Mustafa RR, Rogula TG, et al. Safety of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in elderly patients - analysis of the MBSAQIP. Surg Obes Relat Dis. 2018;14:1276–82.PubMed Janik MR, Mustafa RR, Rogula TG, et al. Safety of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in elderly patients - analysis of the MBSAQIP. Surg Obes Relat Dis. 2018;14:1276–82.PubMed
41.
Zurück zum Zitat Gondal AB, Hsu CH, Zeeshan M, et al. A frailty index and the impact of frailty on postoperative outcomes in older patients after bariatric surgery. Surg Obes Relat Dis. 2019;15(9):1582–8.PubMed Gondal AB, Hsu CH, Zeeshan M, et al. A frailty index and the impact of frailty on postoperative outcomes in older patients after bariatric surgery. Surg Obes Relat Dis. 2019;15(9):1582–8.PubMed
43.
Zurück zum Zitat Prasad J, Vogels E, Dove JT, et al. Is age a real or perceived discriminator for bariatric surgery? A long-term analysis of bariatric surgery in the elderly. Surg Obes Relat Dis. 2019;15:725–31.PubMed Prasad J, Vogels E, Dove JT, et al. Is age a real or perceived discriminator for bariatric surgery? A long-term analysis of bariatric surgery in the elderly. Surg Obes Relat Dis. 2019;15:725–31.PubMed
44.
Zurück zum Zitat Almerie MQ, Rao VSR, Peter MB, et al. The impact of laparoscopic gastric bypass on comorbidities and quality of life in the older obese patients (age > 60): our UK experience. Obes Surg. 2018;28(12):3890–4.PubMed Almerie MQ, Rao VSR, Peter MB, et al. The impact of laparoscopic gastric bypass on comorbidities and quality of life in the older obese patients (age > 60): our UK experience. Obes Surg. 2018;28(12):3890–4.PubMed
45.
Zurück zum Zitat O’Keefe KL, Kemmeter PR, Kemmeter KD. Bariatric surgery outcomes in patients aged 65 years and older at an American Society for Metabolic and Bariatric Surgery Center of Excellence. Obes Surg. 2010;20(9):1199–205.PubMed O’Keefe KL, Kemmeter PR, Kemmeter KD. Bariatric surgery outcomes in patients aged 65 years and older at an American Society for Metabolic and Bariatric Surgery Center of Excellence. Obes Surg. 2010;20(9):1199–205.PubMed
Metadaten
Titel
Is Laparoscopic Bariatric Surgery Safe and Effective in Patients over 60 Years of Age?” an Updated Systematic Review and Meta-Analysis
verfasst von
Antoine Vallois
Benjamin Menahem
Arnaud Alves
Publikationsdatum
08.10.2020
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2020
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04994-3

Weitere Artikel der Ausgabe 12/2020

Obesity Surgery 12/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.