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

Abstract

Background: Advanced age is considered to be a relative contraindication to bariatric surgery because of increased perioperative risk and suboptimal excess weight loss.

Objectives: The 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).

Setting: Hospital clinic, Barcelona, Spain.

Methods: A retrospective analysis of all cases of SG in patients≥60 years old between January 2006 and December 2012 was performed.

Results: The 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.

Conclusions: SG is a safe and feasible procedure in the elderly with results comparable to those in the standard bariatric population.

Keywords: Co-morbidities; Elderly; Sleeve gastrectomy; Weight loss.