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Erschienen in: Obesity Surgery 9/2013

01.09.2013 | Clinical Research

Sleeve Gastrectomy in the Elderly: A Safe and Effective Procedure with Minimal Morbidity and Mortality

verfasst von: Flavia C. Soto, Vicente Gari, Javier R. de la Garza, Samuel Szomstein, Raul J. Rosenthal

Erschienen in: Obesity Surgery | Ausgabe 9/2013

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Abstract

Background

Previously, we demonstrated the safety and efficacy of laparoscopic gastric bypass surgery in patients over 65 years of age. The aim of this study is to demonstrate the safety and efficacy of this procedure as a final step for treatment of morbid obesity in the same population.

Methods

A retrospective review of a prospectively collected database was performed. Between 2004 and 2010, a total of 35 patients age 60 and greater were analyzed from a total of 512 sleeve gastrectomy patients. Demographics, preoperative body mass index, complications, and excess weight loss were recorded and compared to bougie size and follow-up in months. Mean age was 66.3 years (range, 60–79 years), mean body mass index was 46.3 kg/m2 (range, 33.7–77.6 kg/m2), and mean excess weight loss was 148.49 lb (range, 72–252 lb).

Results

One patient (2.8 %) had an incidental colotomy as a result of trocar insertion, one patient (2.0 %) bled, and one patient (2.8 %) had small-bowel enterotomy. Overall, morbidity was 8.4 % with no mortality. Mean percent excess weight loss results for bougie size 52 were 28, 34, 26, 18, and 27 % at 3, 6, 12, 24 and 48 months, respectively; for bougie size 46 were 31, 57, 64, 62, and 82 % at 3, 6, 12, 24 and 48 months, respectively; and bougie size 38 were 37, 50, 55, and 56 % at 3, 6, 12 and 24 months, respectively.

Conclusions

Laparoscopic sleeve gastrectomy is an effective procedure for morbidly obese patients age 60 and greater that can be performed safely.
Literatur
2.
Zurück zum Zitat Arterburn DE, Crane PK, Sullivan SD. The coming epidemic of obesity in elderly Americans. J Am Geriatr Soc. 2004;52(11):1907–12.PubMedCrossRef Arterburn DE, Crane PK, Sullivan SD. The coming epidemic of obesity in elderly Americans. J Am Geriatr Soc. 2004;52(11):1907–12.PubMedCrossRef
3.
Zurück zum Zitat Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.PubMedCrossRef Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.PubMedCrossRef
5.
Zurück zum Zitat Arias E, Martínez PR, Ka Ming Li V, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19(5):544–8. Arias E, Martínez PR, Ka Ming Li V, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19(5):544–8.
6.
Zurück zum Zitat Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the US, 2000. JAMA. 2004;291:1238–45. Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the US, 2000. JAMA. 2004;291:1238–45.
7.
Zurück zum Zitat Printen KJ, Mason EE. Gastric bypass for morbid obesity in patients more than fifty years of age. Surg Gynecol Obstet. 1977;144:192–4.PubMed Printen KJ, Mason EE. Gastric bypass for morbid obesity in patients more than fifty years of age. Surg Gynecol Obstet. 1977;144:192–4.PubMed
8.
Zurück zum Zitat Burton T, Foster WR, Hirsh J, et al. Health implications of obesity: an NIH consensus development conference. Int J Obes. 1985;9:155–70. Burton T, Foster WR, Hirsh J, et al. Health implications of obesity: an NIH consensus development conference. Int J Obes. 1985;9:155–70.
9.
Zurück zum Zitat Rosenthal RJ, Szomstein S, Kennedy CI, et al. Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at The Bariatric Institute Cleveland Clinic Florida. Obes Surg. 2006;16(2):119–24. Rosenthal RJ, Szomstein S, Kennedy CI, et al. Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at The Bariatric Institute Cleveland Clinic Florida. Obes Surg. 2006;16(2):119–24.
10.
Zurück zum Zitat Gonzalvo JP, Antozzi P, Gordon R, et al. Is laparoscopic gastric bypass surgery safe in the elderly? Surg Obes Relat Dis. 2005;1(3):292. Gonzalvo JP, Antozzi P, Gordon R, et al. Is laparoscopic gastric bypass surgery safe in the elderly? Surg Obes Relat Dis. 2005;1(3):292.
11.
Zurück zum Zitat Trieu HT, Gonzalvo JP, Szomstein S, et al. Safety and outcomes of laparoscopic gastric bypass surgery in patients 60 years of age and older. Surg Obes Relat Dis. 2007;3(3):383–6. Trieu HT, Gonzalvo JP, Szomstein S, et al. Safety and outcomes of laparoscopic gastric bypass surgery in patients 60 years of age and older. Surg Obes Relat Dis. 2007;3(3):383–6.
12.
Zurück zum Zitat Busetto L, Angrisani L, Basso N, et al. Safety and efficacy of laparoscopic adjustable gastric banding in elderly. Obesity. 2008;16(2):334–8.PubMedCrossRef Busetto L, Angrisani L, Basso N, et al. Safety and efficacy of laparoscopic adjustable gastric banding in elderly. Obesity. 2008;16(2):334–8.PubMedCrossRef
13.
Zurück zum Zitat Willkomm CM, Fisher TL, Barnes GS, et al. Surgical weight loss >65 years old: is it worth the risk? Surg Obes Relat Dis. 2008;6(5):491–6.CrossRef Willkomm CM, Fisher TL, Barnes GS, et al. Surgical weight loss >65 years old: is it worth the risk? Surg Obes Relat Dis. 2008;6(5):491–6.CrossRef
14.
Zurück zum Zitat Higa KD, Ho T, Boone LB. Laparoscopic Roux-en-Y gastric bypass: technique and 3-year follow-up. J Laparoendosc Adv Surg Tech. 2001;11:377–82.CrossRef Higa KD, Ho T, Boone LB. Laparoscopic Roux-en-Y gastric bypass: technique and 3-year follow-up. J Laparoendosc Adv Surg Tech. 2001;11:377–82.CrossRef
15.
Zurück zum Zitat DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–5.PubMedCrossRef DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640–5.PubMedCrossRef
16.
Zurück zum Zitat Schauer PR, Ikramuddin SS, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y bypass for morbid obesity. Ann Surg. 2000;232:515–29.PubMedCrossRef Schauer PR, Ikramuddin SS, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y bypass for morbid obesity. Ann Surg. 2000;232:515–29.PubMedCrossRef
17.
Zurück zum Zitat O’Brien PE, Dixon JB. Weight loss and early and late complications—the international experience. Am J Surg. 2002;184:42s–5s.PubMedCrossRef O’Brien PE, Dixon JB. Weight loss and early and late complications—the international experience. Am J Surg. 2002;184:42s–5s.PubMedCrossRef
18.
Zurück zum Zitat Weiner R, Wagner D, Bockhorn H. Laparoscopic gastric banding for morbid obesity. J Laparoendosc Adv Surg Tech. 1999;9:23–30.CrossRef Weiner R, Wagner D, Bockhorn H. Laparoscopic gastric banding for morbid obesity. J Laparoendosc Adv Surg Tech. 1999;9:23–30.CrossRef
19.
Zurück zum Zitat Tucker ON, Szomstein S, Rosenthal R. indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12(4):662–7.PubMedCrossRef Tucker ON, Szomstein S, Rosenthal R. indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12(4):662–7.PubMedCrossRef
20.
Zurück zum Zitat Mognol P, Choisdow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15:1030–3.PubMedCrossRef Mognol P, Choisdow D, Marmuse JP. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg. 2005;15:1030–3.PubMedCrossRef
21.
Zurück zum Zitat Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.PubMedCrossRef Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.PubMedCrossRef
22.
Zurück zum Zitat Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high risk super-obese patient. Obes Surg. 2004;14:492–7.PubMedCrossRef Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high risk super-obese patient. Obes Surg. 2004;14:492–7.PubMedCrossRef
23.
Zurück zum Zitat Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.PubMedCrossRef Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.PubMedCrossRef
24.
Zurück zum Zitat Lee CM, Cirangle PT, Jossart GH. Vertical gastrectomy for morbid obesity in 216 patients report of two-year results. Surg Endosc. 2007;21(10):1810–6.PubMedCrossRef Lee CM, Cirangle PT, Jossart GH. Vertical gastrectomy for morbid obesity in 216 patients report of two-year results. Surg Endosc. 2007;21(10):1810–6.PubMedCrossRef
25.
Zurück zum Zitat Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.PubMedCrossRef Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.PubMedCrossRef
26.
Zurück zum Zitat Han SM, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRef Han SM, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRef
27.
Zurück zum Zitat Louise Gagnon. American Society for Metabolic and Bariatric Surgery (ASMBS) 26th Annual Meeting: Abstract PL-207. Presented June 25, 2009 Louise Gagnon. American Society for Metabolic and Bariatric Surgery (ASMBS) 26th Annual Meeting: Abstract PL-207. Presented June 25, 2009
28.
Zurück zum Zitat Melissas J, Koukourakis S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17:57–62.PubMedCrossRef Melissas J, Koukourakis S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17:57–62.PubMedCrossRef
29.
Zurück zum Zitat Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy a food limiting operation. Obes Surg. 2008;18:1251–6.PubMedCrossRef Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy a food limiting operation. Obes Surg. 2008;18:1251–6.PubMedCrossRef
30.
Zurück zum Zitat Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.PubMedCrossRef Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.PubMedCrossRef
Metadaten
Titel
Sleeve Gastrectomy in the Elderly: A Safe and Effective Procedure with Minimal Morbidity and Mortality
verfasst von
Flavia C. Soto
Vicente Gari
Javier R. de la Garza
Samuel Szomstein
Raul J. Rosenthal
Publikationsdatum
01.09.2013
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 9/2013
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-0992-1

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