S Giordano1,2,3, M Victorzon2,4. 1. 1 Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland. 2. 2 University of Turku, Turku, Finland. 3. 3 Department of Surgery, Welfare District of Forssa, Forssa, Finland. 4. 4 Department of Gastrointestinal Surgery, Vaasa Central Hospital, Vaasa, Finland.
Abstract
BACKGROUND AND AIMS: Elderly patient might experience an increased risk of complications after laparoscopic Roux-en-Y gastric bypass. We aimed to perform a meta-analysis of comparative studies on this issue in patients aged 60 years or older. MATERIAL AND METHODS: A systematic literature search was performed. Medline, Cochrane Library, Embase, Scopus, and Google Scholar were searched until July 2016 for studies on outcomes of laparoscopic Roux-en-Y gastric bypass in elderly versus younger patients. Primary outcomes were mortality and overall complications. Secondary outcomes were length of hospital stay, excess weight loss percentage, effect on diabetes, hypertension, hyperlipidemia and obstructive sleep apnea. Heterogeneity across the studies was evaluated by the I2 test, and a random effects model was used. Results were expressed as mean difference and risk ratio (RR). RESULTS: Seven studies involving 3128 patients were retrieved and included in this study. A significantly increased risk of mortality and overall complications was observed among patients older than 60 years compared with younger ones (RR, 6.12; 95% confidence interval 1.08-34.83; p = 0.04; RR, 1.51; 95% confidence interval 1.07-2.11; p = 0.02). Particularly, elderly patients experienced 1% increased risk of mortality and 3% increased risk of overall complications. Length of stay, diabetes, and obstructive sleep apnea remission rates were similar among the groups. Excess weight loss percentage was significantly greater among younger patients (mean difference, -3.44; 95% confidence interval -5.20, -1.68; p < 0.001), as were hypertension (RR, 0.57; 95% confidence interval 0.42-0.76; p < 0.001) and hyperlipidemia (RR, 0.61; 95% confidence interval 0.45-0.83; p = 0.002) remission rates. CONCLUSION: Laparoscopic Roux-en-Y gastric bypass in patients older than 60 years may be a risky bariatric surgery operation due to higher complications and mortality and may not be as effective as in patients younger than 60 years. Thus, older patients should be carefully counseled before this procedure for individual risk-benefit assessment.
BACKGROUND AND AIMS: Elderly patient might experience an increased risk of complications after laparoscopic Roux-en-Y gastric bypass. We aimed to perform a meta-analysis of comparative studies on this issue in patients aged 60 years or older. MATERIAL AND METHODS: A systematic literature search was performed. Medline, Cochrane Library, Embase, Scopus, and Google Scholar were searched until July 2016 for studies on outcomes of laparoscopic Roux-en-Y gastric bypass in elderly versus younger patients. Primary outcomes were mortality and overall complications. Secondary outcomes were length of hospital stay, excess weight loss percentage, effect on diabetes, hypertension, hyperlipidemia and obstructive sleep apnea. Heterogeneity across the studies was evaluated by the I2 test, and a random effects model was used. Results were expressed as mean difference and risk ratio (RR). RESULTS: Seven studies involving 3128 patients were retrieved and included in this study. A significantly increased risk of mortality and overall complications was observed among patients older than 60 years compared with younger ones (RR, 6.12; 95% confidence interval 1.08-34.83; p = 0.04; RR, 1.51; 95% confidence interval 1.07-2.11; p = 0.02). Particularly, elderly patients experienced 1% increased risk of mortality and 3% increased risk of overall complications. Length of stay, diabetes, and obstructive sleep apnea remission rates were similar among the groups. Excess weight loss percentage was significantly greater among younger patients (mean difference, -3.44; 95% confidence interval -5.20, -1.68; p < 0.001), as were hypertension (RR, 0.57; 95% confidence interval 0.42-0.76; p < 0.001) and hyperlipidemia (RR, 0.61; 95% confidence interval 0.45-0.83; p = 0.002) remission rates. CONCLUSION: Laparoscopic Roux-en-Y gastric bypass in patients older than 60 years may be a risky bariatric surgery operation due to higher complications and mortality and may not be as effective as in patients younger than 60 years. Thus, older patients should be carefully counseled before this procedure for individual risk-benefit assessment.
Authors: Styliani Mantziari; Anna Dayer; Céline Duvoisin; Nicolas Demartines; Pierre Allemann; Jean-Marie Calmes; Lucie Favre; Pierre Fournier; Michel Suter Journal: Obes Surg Date: 2020-04 Impact factor: 4.129
Authors: Ivy N Haskins; Tammy Ju; Ashlyn E Whitlock; Lisbi Rivas; Richard L Amdur; Paul P Lin; Khashayar Vaziri Journal: Obes Surg Date: 2018-09 Impact factor: 4.129
Authors: Antonio J Martínez-Ortega; Gabriel Olveira; José L Pereira-Cunill; Carmen Arraiza-Irigoyen; José M García-Almeida; José A Irles Rocamora; María J Molina-Puerta; Juan B Molina Soria; Juana M Rabat-Restrepo; María I Rebollo-Pérez; María P Serrano-Aguayo; Carmen Tenorio-Jiménez; Francisco J Vílches-López; Pedro P García-Luna Journal: Nutrients Date: 2020-07-06 Impact factor: 5.717