Safety and short-term outcomes of laparoscopic sleeve gastrectomy for patients over 65 years old with severe obesity

Abstract

BackgroundLaparoscopic sleeve gastrectomy (LSG) is a widely accepted, stand-alone bariatric operation. Data on elderly patients undergoing LSG are scarce. ObjectivesThe aim of this study was to demonstrate that LSG is safe and effective for patients>65 years old with severe obesity. SettingDepartment of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, Paris-Saclay University, France. MethodsProspectively collected data from consecutive patients undergoing LSG were retrospectively analyzed. Patients with>1-year follow-up were included in the analysis for weight loss and co-morbidities evaluation. Quality of life was evaluated using the Short-Form 36 questionnaire. ResultsFifty-four patients>65 years old (range, 65–75 yr) underwent LSG. Median weight was 119 kg, and median body mass index was 43 kg/m2. Median duration of surgery was 86.5 minutes. Two patients (3.7%) suffered a gastric staple-line leak, 1 treated by pure endoscopic internal drainage and 1 by relaparoscopy with subsequent endoscopic internal drainage. Mortality was null. Median length of hospital stay was 5 days. Six, 12, and 24 months after LSG, median body mass index decreased significantly to 35, 32.9, and 30.7 kg/m2, respectively (P<.0001), with mean excess weight loss of 76.3% at 2 years. Type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea syndrome, and arthralgia showed statistically significant remission at 1- and 2-year follow-up, while 6 of 8 SF-36 scale scores of quality of life assessment improved significantly. ConclusionsThis study suggests that LSG is effective for patients>65 years old, resulting in significant weight loss, co-morbidities remission, and quality of life improvement. Careful patient selection after adequate risk versus benefit evaluation by an expert multidisciplinary team is essential for patient safety and optimal results.