Denis Pajecki1, Anna Carolina Batista Dantas1, Francisco Tustumi2,3, Ana Lumi Kanaji4, Roberto de Cleva1, Marco Aurelio Santo1. 1. Bariatric and Metabolic Surgery Unit, Discipline of Gastroenterology, Universidade de São Paulo, Sao Paulo, Brazil. 2. Bariatric and Metabolic Surgery Unit, Discipline of Gastroenterology, Universidade de São Paulo, Sao Paulo, Brazil. franciscotustumi@gmail.com. 3. Discipline of Gastroenterology, Universidade de São Paulo, Sao Paulo, Brazil. franciscotustumi@gmail.com. 4. Division of Geriatrics, Department of Internal Medicine, Universidade de São Paulo, Sao Paulo, Brazil.
Abstract
PURPOSE: Despite the increasing prevalence of elderly obese patients, bariatric surgery remains controversial in this population. Recent publications have focused on perioperative safety, but few studies have addressed clinical outcomes. OBJECTIVES: This study aimed to evaluate 1-year outcomes of laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients 65 years or older. METHODS: Thirty-six elderly obese patients were recruited for an open-label randomized trial from September 2017 to May 2019, comparing LSG to LRYGB. One-year outcomes were evaluated based on weight loss, functionality, and control of clinical conditions. RESULTS: The median age (67 × 67 years; p=0.67) and initial body mass index (BMI) (46.3 × 51.3 kg/m2; p=0.28) were similar between groups. Preoperative BMI (after weight loss pre-operative treatment) was higher in LRYGB group (41.9 × 47.6 kg/m2; p= 0.03). After 12 months, EWL and TWL were higher in LRYGB group (60 × 68%; p=0.04; 24.9 × 31.4%; p<0.01). HbA1c reduction was higher after LRYGB (-1.1 × -0.5%; p<0.01) as well as LDL control (-27.5 × +11.5 mg/dL p= 0.02). No difference was noted between LRYGB and LSG concerning hypertension control, triglycerides, HDL, and functionality. CONCLUSION: Weight loss, diabetes, and LDL control were better achieved with LRYGB after 12 months.
PURPOSE: Despite the increasing prevalence of elderly obese patients, bariatric surgery remains controversial in this population. Recent publications have focused on perioperative safety, but few studies have addressed clinical outcomes. OBJECTIVES: This study aimed to evaluate 1-year outcomes of laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients 65 years or older. METHODS: Thirty-six elderly obese patients were recruited for an open-label randomized trial from September 2017 to May 2019, comparing LSG to LRYGB. One-year outcomes were evaluated based on weight loss, functionality, and control of clinical conditions. RESULTS: The median age (67 × 67 years; p=0.67) and initial body mass index (BMI) (46.3 × 51.3 kg/m2; p=0.28) were similar between groups. Preoperative BMI (after weight loss pre-operative treatment) was higher in LRYGB group (41.9 × 47.6 kg/m2; p= 0.03). After 12 months, EWL and TWL were higher in LRYGB group (60 × 68%; p=0.04; 24.9 × 31.4%; p<0.01). HbA1c reduction was higher after LRYGB (-1.1 × -0.5%; p<0.01) as well as LDL control (-27.5 × +11.5 mg/dL p= 0.02). No difference was noted between LRYGB and LSG concerning hypertension control, triglycerides, HDL, and functionality. CONCLUSION: Weight loss, diabetes, and LDL control were better achieved with LRYGB after 12 months.
Authors: Francesco M Carrano; Angelo Iossa; Nicola Di Lorenzo; Gianfranco Silecchia; Katerina-Maria Kontouli; Dimitris Mavridis; Isaias Alarçon; Daniel M Felsenreich; Sergi Sanchez-Cordero; Angelo Di Vincenzo; M Carmen Balagué-Ponz; Rachel L Batterham; Nicole Bouvy; Catalin Copaescu; Dror Dicker; Martin Fried; Daniela Godoroja; David Goitein; Jason C G Halford; Marina Kalogridaki; Maurizio De Luca; Salvador Morales-Conde; Gerhard Prager; Andrea Pucci; Ramon Vilallonga; Iris Zani; Per Olav Vandvik; Stavros A Antoniou Journal: Surg Endosc Date: 2022-01-20 Impact factor: 4.584
Authors: Maria V Matteo; Vincenzo Bove; Valerio Pontecorvi; Martina De Siena; Gabriele Ciasca; Massimiliano Papi; Giulia Giannetti; Giorgio Carlino; Marco Raffaelli; Guido Costamagna; Ivo Boškoski Journal: Obes Surg Date: 2022-08-02 Impact factor: 3.479