Is sleeve gastrectomy still contraindicated for patients aged≥60 years? A case-matched study with 24 months of follow-up

Aurelien Pequignot; Flavien Prevot; Abdennaceur Dhahri; Lionel Rebibo; Rachid Badaoui; Jean Marc Regimbeau

doi:10.1016/j.soard.2014.11.015

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 Sep-Oct;11(5):1008-13. doi: 10.1016/j.soard.2014.11.015. Epub 2014 Nov 28.

Authors

Aurelien Pequignot¹, Flavien Prevot¹, Abdennaceur Dhahri¹, Lionel Rebibo¹, Rachid Badaoui², Jean Marc Regimbeau³

Affiliations

¹ Departments of Digestive Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
² Departments of Anesthesiology, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France.
³ Departments of Digestive Surgery, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France. Electronic address: [email protected].

PMID: 25863533
DOI: 10.1016/j.soard.2014.11.015

Abstract

Background: Current guidelines consider that bariatric surgery is relatively contraindicated in elderly adults (aged≥60 years). The objective of this study was to evaluate obesity-related morbidity after sleeve gastrectomy (SG) according to whether patients were aged≥60 years or<60 years.

Methods: Forty-two patients aged≥60 years (the elderly group) were matched 1:2 with 84 patients aged<60 (the control group). The primary objective was to compare weight change and the remission rate of co-morbidities in the 2 groups after 24 months of follow-up. The secondary endpoints were short-term and midterm postoperative outcomes (operating time, the frequency of conversion to laparotomy, the length of hospital stay, postoperative complications, mortality, and the SG failure rate).

Results: No significant differences were observed between the elderly and control groups in terms of the mean operating time (83 minutes in both groups; P = .90), length of stay (3.2 versus 3.4 days, respectively; P = .51), morbidity rate (4.7% versus 9.5%, P = .35), or mortality rate (0% in both groups). The mean excess weight loss was significantly lower in the elderly group than in the control group at 12 months (56.2% versus 71.4%, respectively; P<.01) and 24 months (51.8% versus 73.5%, P<.01). Similar statistically significant differences were observed between the elderly group and control group for remission of metabolic syndrome (95% versus 90%, respectively; P = .55), type 2 diabetes mellitus (87% versus 71%, respectively; P = .13), hypertension (81% versus 77%, respectively; P = .71), and dyslipidemia (94% versus 74%, respectively; P = .09) at 24 months after SG.

Conclusion: Results support the safety and efficacy of SG for morbid obesity in patients aged≥60 years. In contrast to weight loss, the long-term morbidity rate and remission of obesity-related co-morbidities were similar in the participants aged≥60 years and those aged<60 years.

Keywords: Co-morbidities; Elderly patients; Excess weight loss; Morbidity; Mortality; Sleeve gastrectomy.

Publication types

Comparative Study

MeSH terms

Adult
Age Factors
Aged
Aging / physiology
Bariatric Surgery / adverse effects
Bariatric Surgery / methods
Body Mass Index
Case-Control Studies
Comorbidity*
Female
Follow-Up Studies
France
Gastrectomy / adverse effects
Gastrectomy / methods*
Gastrectomy / mortality
Humans
Male
Middle Aged
Obesity, Morbid / diagnosis
Obesity, Morbid / mortality
Obesity, Morbid / surgery*
Patient Safety / statistics & numerical data*
Postoperative Complications / mortality
Postoperative Complications / physiopathology
Reference Values
Retrospective Studies
Risk Assessment
Survival Rate
Time Factors
Treatment Outcome
Weight Loss / physiology*