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Postoperative Outcomes of Laparoscopic Bariatric Surgery in Older Obese Patients: a Matched Case-Control Study

Abstract

Background

Laparoscopic bariatric surgery (LBS) in older obese patients remains debated regarding postoperative outcomes.

Objectives

The aim of this case-control study is to evaluate global results of LBS in patients ≥60 years (yr) with a matched case control study.

Methods

All patients ≥60 years who benefited from LBS in our center between January 2009 and January 2014 were included in this retrospective study. They were matched (1:2) to patients <40 and 40–59 years on BMI, surgical procedure and year, and history of previous LBS. Postoperative complications in the first 90 days following LBS, micronutrient and mineral deficiencies, and Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed.

Results

Fifty-five patients ≥60 year (40 sleeve gastrectomy, 14 one anastomosis gastric bypass, 1 gastric bypass revision) were matched to patients <40 year and patients 40–59 year (n = 55 each). Patients ≥60 year presented more obesity-related comorbidities at baseline. Except for bleeding complications (P = 0.01), no difference in major complication rate was observed (P = 0.43). At 24 months, %EWL was lower in older patients compared to others (76.3, 82.2 and 89.7, respectively, P = 0.009). Iron and vitamin B12 deficiencies were less prevalent in patients ≥60 year After a mean follow-up of 27 months, BAROS score (filled in by 82% of patients) was lower in patients ≥60 years (P = 0.01).

Conclusion

Despite less weight loss, postoperative complications rate, and lower BAROS results, LBS keeps an acceptable benefit-risk balance in selected older patients and should not be rejected on the sole argument of age. Additional studies are needed to assess the long-term benefits of LBS in older patients.

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Abbreviations

BAROS:

Bariatric analysis and reporting outcome system

BMI:

Body mass index

BS:

Bariatric surgery

GERD:

Gastroesophageal reflux disease

LBS:

Laparoscopic bariatric surgery

LOAGBP:

Laparoscopic one anastomosis gastric bypass

LSG:

Laparoscopic sleeve gastrectomy

MC:

Major complication

NAFLD:

Nonalcoholic fatty liver disease

%EWL:

Percentage of excess weight loss

QOL:

Quality of life

SD:

Standard deviation

T2D:

Type 2 diabetes

Yr:

Years

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Authors’ Contributions

Study concept and design: VB, DL, DB.

Acquisition of data: VB.

Analysis and interpretation of data: VB, DB, RT.

Drafting of the manuscript: DB, RT.

Critical revision of the manuscript for important intellectual content: DL, VB, AG.

Statistical analysis: VB.

Obtained funding: None.

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Authors

Corresponding author

Correspondence to Damien Bergeat.

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Funding

There was no financial support for this study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Does not apply.

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Bergeat, D., Lechaux, D., Ghaina, A. et al. Postoperative Outcomes of Laparoscopic Bariatric Surgery in Older Obese Patients: a Matched Case-Control Study. OBES SURG 27, 1414–1422 (2017). https://doi.org/10.1007/s11695-016-2517-1

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Keywords

  • Older patients
  • Bariatric surgery
  • Laparoscopic sleeve gastrectomy
  • Laparoscopic one anastomosis gastric bypass
  • Obesity-related comorbidities
  • Mineral and micronutrient deficiencies
  • BAROS
  • Quality of life