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Increased Metabolic Benefit for Obese, Elderly Patients Undergoing Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy

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Abstract

Purpose

We sought to assess outcomes of laparoscopic sleeve gastrectomy (LSG) vs laparoscopic Roux-en-Y gastric bypass (LRYGB) in a cohort of morbidly obese, elderly patients.

Materials and Methods

Retrospective review was conducted of all patients age 60 years or greater undergoing LSG or LRYGB at our institution between 2007 and 2014.

Results

A total of 134 patients who underwent LSG (n = 65) or LRYGB (n = 69) were identified. Groups were similar with respect to age (64 years, range 60–75 years), BMI (44.0 ± 6.1), and ASA score (91% ≥ ASA 3). There were no differences in major post-operative complications (3, 4.7% LSG vs 4, 5.8% LRYGB, p = 0.75). Median follow-up was 39 months (IQR 14–64 months) with no patients lost to follow-up. Patients undergoing LRYGB had improvement in each of diabetes mellitus 2 (DM2), hypertension (HTN), hyperlipidemia (HL), and gastroesophageal reflux disease (GERD) as well as a significant decrease in insulin use (16/47, 34.0% pre-operatively vs 7/47, 15.2% post-operatively; p = 0.03). Patients undergoing LSG had improvement in DM2 and HTN but not in HL or GERD; there was no reduction in insulin dependence. Weight loss was not significantly different between groups; mean percent total weight loss at 36 months was 26.9 ± 9.0% in the LSG group and 23.9 ± 9.3% in the LRYGB group, p = 0.24.

Conclusions

Both LSG and RYGB can be safely performed on morbidly obese, elderly adults. At intermediate follow-up, there is an increased metabolic benefit for elderly patients undergoing LRYGB over LSG.

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Acknowledgements

We thank Aaron Burshtein and Joshua Burshtein for data collection.

Funding

This study was internally funded.

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Authors and Affiliations

  1. Department of Surgery, New York Presbyterian Hospital—Weill Cornell Medicine, 1300 York Ave. A1027, New York, NY, 10065, USA

    Katherine D. Gray, Maureen D. Moore, Omar Bellorin, Jonathan S. Abelson, Gregory Dakin, Rasa Zarnegar, Alfons Pomp & Cheguevara Afaneh

  2. 525 E 68th St, Box 294, New York, NY, 10021, USA

    Cheguevara Afaneh

Authors
  1. Katherine D. Gray
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  2. Maureen D. Moore
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  3. Omar Bellorin
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  4. Jonathan S. Abelson
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  5. Gregory Dakin
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  6. Rasa Zarnegar
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  7. Alfons Pomp
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  8. Cheguevara Afaneh
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Corresponding author

Correspondence to Cheguevara Afaneh.

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Disclosures

Dr. Afaneh reports honoraria from Intuitive Surgical, outside the submitted work. Dr. Dakin reports honoraria from Medtronic, outside the submitted work. Dr. Pomp reports honoraria from WL Gore & Associates, Medtronic, and Ethicon, outside the submitted work. Drs. Gray, Moore, Bellorin, Abelson, and Zarnegar have nothing to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Gray, K.D., Moore, M.D., Bellorin, O. et al. Increased Metabolic Benefit for Obese, Elderly Patients Undergoing Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy. OBES SURG 28, 636–642 (2018). https://doi.org/10.1007/s11695-017-2904-2

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  • DOI: https://doi.org/10.1007/s11695-017-2904-2

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