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Erschienen in: Obesity Surgery 11/2016

16.03.2016 | Original Contributions

Laparoscopic Sleeve Gastrectomy and Gastric Bypass for The Aging Population

verfasst von: James Yoon, Jingjing Sherman, Alexandra Argiroff, Edward Chin, Daniel Herron, William Inabnet, Subhash Kini, Scott Nguyen

Erschienen in: Obesity Surgery | Ausgabe 11/2016

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Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most common bariatric surgeries for treating morbid obesity. The purpose of this study is to determine differences in outcomes from RYGB or SG between patients ages ≥ 60 years and < 60 years.

Methods

A retrospective review of patients who underwent RYGB and SG at our institution from 01/2008 to 05/2012 was conducted. Forty patients from each group (≥60 years and < 60 years) were matched based on gender, body mass index (BMI), co-morbidities, and type of bariatric surgery performed, and their charts were reviewed up to 1 year post-operatively. Primary end points measured were mean length of stay, operative time, incidence of complications, and readmissions in the first post-operative year. A secondary end point measured was percent total weight loss (%TWL) and excess weight loss (%EWL).

Results

There were no significant differences between group < 60 and group ≥ 60 in operative time (210 vs. 229 min; p = 0.177), in-hospital post-operative complication rates (2.5 vs. 5 %; p = 1.0), long-term complication rates (2.5 vs. 10 %; p = 0.359), and 30-day readmission rates (2.5 vs. 12.5 %; p = 0.2). Patients in group < 60 had shorter lengths of stay (2.2 vs. 2.7 days; p = 0.031), but this difference is not clinically significant. Both groups achieved similar %TWL (21.4 vs. 20.5 %; p = 0.711) and %EWL (50.6 vs. 50.7 %; p = 0.986).

Conclusions

Advanced age (≥60 years) is not a significant predictor of a worse outcome for SG and RYGB.
Literatur
1.
Zurück zum Zitat Fakhouri TH, Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among older adults in the United States, 2007–2010. NCHS Data Brief. 2012(106):1–8. Fakhouri TH, Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among older adults in the United States, 2007–2010. NCHS Data Brief. 2012(106):1–8.
2.
Zurück zum Zitat Gallagher Camden S, Gates J. Obesity: changing the face of geriatric care. Ostomy Wound Manage. 2006;52(10):36–8. 40–34.PubMed Gallagher Camden S, Gates J. Obesity: changing the face of geriatric care. Ostomy Wound Manage. 2006;52(10):36–8. 40–34.PubMed
3.
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(10):1662–9.CrossRefPubMed 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(10):1662–9.CrossRefPubMed
4.
Zurück zum Zitat Smith E, Hay P, Campbell L, et al. A review of the association between obesity and cognitive function across the lifespan: implications for novel approaches to prevention and treatment. Obes Rev. 2011;12(9):740–55.CrossRefPubMed Smith E, Hay P, Campbell L, et al. A review of the association between obesity and cognitive function across the lifespan: implications for novel approaches to prevention and treatment. Obes Rev. 2011;12(9):740–55.CrossRefPubMed
6.
Zurück zum Zitat Cummings DE, Cohen RV. Beyond BMI: the need for new guidelines governing the use of bariatric and metabolic surgery. Lancet Diabetes Endocrinol. 2014;2(2):175–81.CrossRefPubMedPubMedCentral Cummings DE, Cohen RV. Beyond BMI: the need for new guidelines governing the use of bariatric and metabolic surgery. Lancet Diabetes Endocrinol. 2014;2(2):175–81.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254(3):410–20.CrossRefPubMedPubMedCentral Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254(3):410–20.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity. 2013; S1-27. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity. 2013; S1-27.
9.
Zurück zum Zitat Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82.CrossRefPubMedPubMedCentral Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study. J Gastrointest Surg. 2012;16(1):35–44.CrossRefPubMed Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study. J Gastrointest Surg. 2012;16(1):35–44.CrossRefPubMed
11.
Zurück zum Zitat Hazzan D, Chin EH, Steinhagen E, et al. Laparoscopic bariatric surgery can be safe for treatment of morbid obesity in patients older than 60 years. Surg Obes Relat Dis. 2006;2(6):613–6.CrossRefPubMed Hazzan D, Chin EH, Steinhagen E, et al. Laparoscopic bariatric surgery can be safe for treatment of morbid obesity in patients older than 60 years. Surg Obes Relat Dis. 2006;2(6):613–6.CrossRefPubMed
12.
13.
Zurück zum Zitat Wittgrove AC, Martinez T. Laparoscopic gastric bypass in patients 60 years and older: early postoperative morbidity and resolution of comorbidities. Obes Surg. 2009;19(11):1472–6.CrossRefPubMed Wittgrove AC, Martinez T. Laparoscopic gastric bypass in patients 60 years and older: early postoperative morbidity and resolution of comorbidities. Obes Surg. 2009;19(11):1472–6.CrossRefPubMed
14.
Zurück zum Zitat Sampalis JS, Liberman M, Auger S, et al. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004;14(7):939–47.CrossRefPubMed Sampalis JS, Liberman M, Auger S, et al. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004;14(7):939–47.CrossRefPubMed
Metadaten
Titel
Laparoscopic Sleeve Gastrectomy and Gastric Bypass for The Aging Population
verfasst von
James Yoon
Jingjing Sherman
Alexandra Argiroff
Edward Chin
Daniel Herron
William Inabnet
Subhash Kini
Scott Nguyen
Publikationsdatum
16.03.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 11/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2139-7

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