Salvatore Giordano1, Mikael Victorzon. 1. Department of Plastic and General Surgery, Turku University Hospital, OS 299, PL 52, 20521, Turku, Finland, salvatore.giordano@gmail.com.
Abstract
BACKGROUND: Controversy exists regarding the effectiveness and safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) in elderly patients. We evaluated our outcomes of LRYGB in patients aged ≥ 55 years. METHODS: A total of 549 consecutive patients underwent LRYGB as primary operation and 132 were ≥ 55 years old. Patients were divided in two groups: group <55 years comprised 417 patients, with mean age (± SD) of 41.15 ± 8.47 years; group ≥ 55 years comprised 132 patients, with mean age of 59.43 ± 3.81 years. Mean preoperative body mass index was 47.01 ± 7.47 and 46.21 ± 7.47 respectively, whereas mean excess weight loss percent (EW%) was 88.06 ± 30.28 and 84.86 ± 29.87 %. Early morbidity (30 days) and outcomes at 6, 12, and 24 months follow-up were evaluated. RESULTS: Significant difference was found in operative time (84.19 ± 29.05 vs. 90.89 ± 30.95 min, p = 0.03). One conversion to open procedure occurred in group <55 years, whereas three occurred in group ≥ 55 years (p = 0.04). Intraoperative complications occurred in 22 patients (5.27 %) in group <55 years versus 19 in group ≥ 55 years (14.39 %), which was statistically significant (p = 0.001). One case of death occurred in the younger group. Overall postoperative morbidity rate was 18.7 % in group <55 years and 25.76 % in group ≥ 55 years, with no significant difference (p = 0.08). Mean EWL% at 12 months in group <55 years was 65.95.05 ± 26.96 versus 62.61 ± 41.78 in group ≥ 55 years, whereas at 24 months it was 65.08 ± 29.68 versus 64.48 ± 18.44 with no significant difference between the groups (p = 0.51; p = 0.92). CONCLUSIONS: LRYGB for patients ≥ 55 years achieves outcomes and complications rates comparable to the younger population. Patients should not be denied bariatric surgery for the age alone.
RCT Entities:
BACKGROUND: Controversy exists regarding the effectiveness and safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) in elderly patients. We evaluated our outcomes of LRYGB in patients aged ≥ 55 years. METHODS: A total of 549 consecutive patients underwent LRYGB as primary operation and 132 were ≥ 55 years old. Patients were divided in two groups: group <55 years comprised 417 patients, with mean age (± SD) of 41.15 ± 8.47 years; group ≥ 55 years comprised 132 patients, with mean age of 59.43 ± 3.81 years. Mean preoperative body mass index was 47.01 ± 7.47 and 46.21 ± 7.47 respectively, whereas mean excess weight loss percent (EW%) was 88.06 ± 30.28 and 84.86 ± 29.87 %. Early morbidity (30 days) and outcomes at 6, 12, and 24 months follow-up were evaluated. RESULTS: Significant difference was found in operative time (84.19 ± 29.05 vs. 90.89 ± 30.95 min, p = 0.03). One conversion to open procedure occurred in group <55 years, whereas three occurred in group ≥ 55 years (p = 0.04). Intraoperative complications occurred in 22 patients (5.27 %) in group <55 years versus 19 in group ≥ 55 years (14.39 %), which was statistically significant (p = 0.001). One case of death occurred in the younger group. Overall postoperative morbidity rate was 18.7 % in group <55 years and 25.76 % in group ≥ 55 years, with no significant difference (p = 0.08). Mean EWL% at 12 months in group <55 years was 65.95.05 ± 26.96 versus 62.61 ± 41.78 in group ≥ 55 years, whereas at 24 months it was 65.08 ± 29.68 versus 64.48 ± 18.44 with no significant difference between the groups (p = 0.51; p = 0.92). CONCLUSIONS: LRYGB for patients ≥ 55 years achieves outcomes and complications rates comparable to the younger population. Patients should not be denied bariatric surgery for the age alone.
Authors: Melinda A Maggard; Lisa R Shugarman; Marika Suttorp; Margaret Maglione; Harvey J Sugerman; Harvey J Sugarman; Edward H Livingston; Ninh T Nguyen; Zhaoping Li; Walter A Mojica; Lara Hilton; Shannon Rhodes; Sally C Morton; Paul G Shekelle Journal: Ann Intern Med Date: 2005-04-05 Impact factor: 25.391
Authors: Peter Benotti; G Craig Wood; Deborah A Winegar; Anthony T Petrick; Christopher D Still; George Argyropoulos; Glenn S Gerhard Journal: Ann Surg Date: 2014-01 Impact factor: 12.969
Authors: Beat P Müller-Stich; Lars Fischer; Hannes G Kenngott; Matthias Gondan; Jonas Senft; Gabriella Clemens; Felix Nickel; Thomas Fleming; Peter P Nawroth; Markus W Büchler Journal: Ann Surg Date: 2013-11 Impact factor: 12.969
Authors: Chetan Parmar; Kamal K Mahawar; William R J Carr; Norbert Schroeder; Shlok Balupuri; Peter K Small Journal: Obes Surg Date: 2017-12 Impact factor: 4.129
Authors: Sean J Donohue; Caroline E Reinke; Susan L Evans; Mary M Jordan; Yancey E Warren; Timothy Hetherington; Marc Kowalkowski; Addison K May; Brent D Matthews; Samuel W Ross Journal: Surg Endosc Date: 2021-09-03 Impact factor: 3.453
Authors: Rena C Moon; Flavio Kreimer; Andre F Teixeira; Josemberg M Campos; Alvaro Ferraz; Muhammad A Jawad Journal: Obes Surg Date: 2016-04 Impact factor: 4.129
Authors: Michael Arnold; Sharbel Elhage; Lynnette Schiffern; B Lauren Paton; Samuel W Ross; Brent D Matthews; Caroline E Reinke Journal: Surg Endosc Date: 2019-08-06 Impact factor: 4.584