Sleeve gastrectomy in the elderly: A case-control study with long-term follow-up of 3 years

Abstract

BackgroundAdvanced age is considered to be a relative contraindication to bariatric surgery because of increased perioperative risk and suboptimal excess weight loss. ObjectivesThe aim of this study was to analyze the safety and effectiveness of the sleeve gastrectomy (SG) procedure in a cohort of elderly patients (aged≥60 yr) compared with younger patients (aged<60 yr). SettingHospital clinic, Barcelona, Spain. MethodsA retrospective analysis of all cases of SG in patients≥60 years old between January 2006 and December 2012 was performed. ResultsThe study included 206 patients, 103 in each group. The mean age was 63.3±2.8 years, and the body mass index was 45.8±22.8 kg/m2. The overall complication rate within the elderly group was 9.7% versus 15.5% in the younger group (P = .2). After SG, there was no statistical difference in body mass index between the groups until 24 (33.4 versus 31.5 kg/m2, P = .01) and 36 (34.6 versus 32.8 kg/m2, P = .01) months of follow-up, favoring the younger cohort. Mean percent excess weight loss was similar between the groups during all periods of follow-up. The mean percent total weight loss change was statistically higher in the younger group at 3 (15.1% versus 17.1%, P = .03); 6 (25.2% versus 27.5%, P = .04); 12 (32.4% versus 35.2%, P = .03); 24 (26.7% versus 32.4%, P<.01); and 36 months (24.9% versus 29.1%, P<.01). Neither groups revealed a statistical difference in resolution of all co-morbidities, except for obstructive sleep apnea (P = .02) in the younger group. ConclusionsSG is a safe and feasible procedure in the elderly with results comparable to those in the standard bariatric population.