Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years.

BACKGROUND: Morbidity and mortality following laparoscopic sleeve gastrectomy (LSG) occur at acceptable rates, but its safety and efficacy in the elderly are unknown.
METHODS: A retrospective review was performed of all patients aged >60 years who underwent LSG from 2008 to 2012. These patients were 1:2 matched, by gender and body mass index (BMI) to young patients, 18 < age < 50. Data analyzed included demographics, preoperative and postoperative BMI, postoperative complications, and improvement or resolution of obesity-related comorbidities.
RESULTS: Fifty-two morbid obese patients older than 60 years underwent LSG (mean age, 62.9 ± 0.3 years). These were matched to 104 young patients, age 18-50 years (mean age, 35.7 ± 0.8 years). Groups did not differ in male gender (44 vs. 43%, p = 0.9), preoperative BMI (42.6 ± 0.7 vs. 42.6 ± 0.6, p = 0.97), and length of follow-up (17 ± 2 vs. 22 ± 1.4 months, p = 0.06). Obesity-related comorbidities were significantly higher in the older group (96 vs. 65%, p < 0.001). Excess weight loss (EWL) was higher in the younger group (75 ± 2.4 vs. 62 ± 3%, p = 0.001). Older patients had a significantly higher rate of a concurrent hiatal hernia repair (23 vs. 1.9%, p < 0.001). Overall postoperative minor complication rate was higher in the older group (25 vs. 4.8%, p < 0.001). This included atrial fibrillation (9.5%), urinary tract infection (7%), trocar site hernia (4%), dysphagia, surgical site infection, bleeding, bowel obstruction, colitis, and nutritional deficiency (2%, each). No perioperative mortality occurred. Comorbidity resolution or improvement was comparable between groups (88 vs. 80%, p = 0.13).
CONCLUSIONS: LSG is safe and very efficient in patients aged >60, despite higher rates of perioperative comorbidities.