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Laparoscopic Sleeve Gastrectomy is Safe and Effective in Elderly Patients: A Comparative Analysis

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Abstract

Background

Laparoscopic sleeve gastrectomy (SG) is gaining widespread popularity as a definitive bariatric operation that provides satisfactory and durable weight loss as well as comorbidity resolution. Although SG is being increasingly offered to patients of all ages, there is a paucity of reported outcomes in patients ≥62 years of age. The purpose of this study was to perform a comparative analysis of the outcomes of SG in patients >62 years versus a younger age group, with an emphasis on safety and efficacy.

Methods

A retrospective analysis was performed from a prospectively collected database on patients who underwent SG from 2007 to 2012. All patients who were ≥62 years old were compared to those <62 years.

Results

There were 182 patients who underwent SG, 17 of whom were ≥62 years old. There were no significant differences in demographics or comorbidity characteristics between the groups. The mean follow-up was 1 year. There was no 30-day mortality in either group. The percent excess weight loss for the younger age group was 44 ± 21 % and the older group was 44 ± 25 %. The percent total body weight loss was 22 ± 10 and 21 ± 10 %, respectively. Weight loss outcomes were maintained for up to 3 years. Comorbidity resolution and improvement rates were equivalent in both groups.

Conclusions

SG is safe and effective in patients ≥62 years. Weight loss and the beneficial effects on comorbidities are equivalent among elderly and younger patients. SG should be offered to elderly patients who are deemed to be appropriate candidates.

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References

  1. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends of obesity among US adults, 1998-2008. JAMA. 2010;303:235–41.

    Article  CAS  PubMed  Google Scholar 

  2. Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12:662–7.

    Article  CAS  PubMed  Google Scholar 

  3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systemic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  CAS  PubMed  Google Scholar 

  4. Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238(4):467–85.

    PubMed Central  PubMed  Google Scholar 

  5. Sugerman HJ, Demaria EJ, Kellm JM, et al. Effects of bariatric surgery in older patients. Ann Surg. 2004;240(2):243–7.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Birkmeyer NJ, Dimick JB, Share D, et al. Hospital complication rates with bariatric surgery in Michigan. JAMA. 2010;304:435–42.

    Article  CAS  PubMed  Google Scholar 

  7. Hutter MM, Schirmer BD, Ko CY, 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.

    Article  PubMed Central  PubMed  Google Scholar 

  8. The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. NEJM. 2009;361(5):445–54.

    Article  Google Scholar 

  9. Carlin AM, Zeni TM, English WJ, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg. 2013 Mar 6.

  10. Rosenthal RJ. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience >12,000 cases. Surg Obes Relat Dis. 2012;8:8–19.

    Article  PubMed  Google Scholar 

  11. Bayham B, Greenway F, Bellanger D. Outcomes of the laparoscopic sleeve gastrectomy in the medicare population. Obes Surg. 2012;8

  12. Leivonen MK, Juuti A, Jaser N, et al. Laparoscopic sleeve gastrectomy in patients over 59 years: early recovery and 12-month follow-up. Obes Surg. 2011;21:1180–7.

    Article  PubMed  Google Scholar 

  13. O’Keefe KL, Demmeter 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.

    Article  PubMed  Google Scholar 

  14. Ramirez A, Roy M, Hidalgo JE, et al. Outcomes of bariatric surgery in patients > 70 years old. Surg Obes Relat Dis. 2012;8(4):458–62.

    Article  PubMed  Google Scholar 

  15. Soto FC, Gari V, Garza JR, et al. Sleeve gastrectomy in the elderly: a safe and effective procedure with minimal morbidity and mortality. Obes Surg. 4 June 2013. Epub – published online.

  16. Rutte PWJ, Smulders JF, Zoete JP, et al. Sleeve gastrectomy in older obese individuals. Surg Endosc. 2013;27:2014–9.

    Article  PubMed  Google Scholar 

  17. ASMBS Clinical Issues Committee. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2012;8:e21–6. http://asmbs.org/2013/02/clinical-issues.

    Article  Google Scholar 

  18. Nguyen NT, Nguyen B, Gebhart A, et al. Changes in the makeup of bariatric surgery: a national increase in the use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–7.

    Article  PubMed  Google Scholar 

  19. Boza C, Salinas J, Salgado N, et al. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of a 1,000 cases and 3-year follow-up. Obes Surg. 2012;22(6):866–71.

    Article  PubMed  Google Scholar 

  20. Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93 % follow-up. Ann Surg. 2012;256(2):262–5.

    Article  PubMed  Google Scholar 

  21. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.

    Article  PubMed  Google Scholar 

  22. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22:740–8.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Flum DR, Salem L, Elrod JA, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgery. JAMA. 2005;294:1903–4.

    Article  CAS  PubMed  Google Scholar 

  24. Livingston EH, Langert J. The impact of age and Medicare status on bariatric surgical outcomes. Arch Surg. 2006;141:1115–20.

    Article  PubMed  Google Scholar 

  25. Quebbemann B, Engstrom D, Siegfried T, et al. Bariatric surgery in patients older than 65 years is safe and effective. Surg Obes Relat Dis. 2005;1:389–93.

    Article  PubMed  Google Scholar 

  26. Palmer RM. Perioperative care of the elderly patient: an update. Cleve Clin J Med. 2009;76 Suppl 4:S16–21.

    Article  PubMed  Google Scholar 

  27. Willkomm CM, Fisher TL, Barnes GS, et al. Surgical weight loss >65 years old: is it worth the risk? Surg Obes Relat Dis. 2010;6:491–7.

    Article  PubMed  Google Scholar 

  28. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.

    Article  CAS  PubMed  Google Scholar 

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Conflict of Interest

MAB, DTM, JHC, and SGM have no conflict of interest. DJS has received personal fees as speaker for Ethicon, W.L. Gore, and Cook Biotech, Inc, none of which influenced the submitted work

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

The study was approved by the Indiana University Institutional Review Board and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

Grant Support

Educational Grant for Fellowship Support from the Foundation of Surgical Fellowships

Author information

Authors and Affiliations

  1. Genesis Health Group, 855 Illini Drive, Suite 401, Silvis, IL, 61282, USA

    Michael A. Burchett

  2. Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 203, Indianapolis, IN, 46202, USA

    Daniel T. McKenna, Don J. Selzer & Jennifer H. Choi

  3. Department of Surgery, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Rd, Mail Code: L223A, Portland, OR, 97231, USA

    Samer G. Mattar

Authors
  1. Michael A. Burchett
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  2. Daniel T. McKenna
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  3. Don J. Selzer
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  4. Jennifer H. Choi
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  5. Samer G. Mattar
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Corresponding author

Correspondence to Samer G. Mattar.

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Burchett, M.A., McKenna, D.T., Selzer, D.J. et al. Laparoscopic Sleeve Gastrectomy is Safe and Effective in Elderly Patients: A Comparative Analysis. OBES SURG 25, 222–228 (2015). https://doi.org/10.1007/s11695-014-1421-9

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  • DOI: https://doi.org/10.1007/s11695-014-1421-9

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