Many surgeons are hesitant to offer weight-loss surgery to patients >60 years of age because of concern of the considerably greater operative risk and less weight-control efficacy. In this study, the investigators proposed that laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) can be performed in this patient population with minimal risk and can achieve effective weight control.
A retrospective review was performed of patients >60 years of age who had undergone LRYGB at the Bariatric Institute at Cleveland Clinic Florida from 2001 to 2004. The data assessed included age, gender, pre- and post-operative weight and body mass index (BMI), and post-operative complications. A total of 92 patients >60 years who had undergone LRYGB were reviewed in this study. The mean pre-operative weight and BMI was 136.6 kg and 48.4 kg/m2, respectively. The mean post-operative weight and BMI was 100.3 kg and 35.9 kg/m2, respectively. The mean percentage of excess weight loss was 53.85%. The early complications were an anastomotic leak in 2 patients (2.2%), hemorrhage in 1 patient (1.1%), pulmonary embolus (blood clot on the lung) in 1 patient (1.1%), pneumonia in 1 patient (1.1%), and atrial fibrillation (an abnormal heart rhythm) in 1 patient (1.1%). The late complications included narrowing at the gastrojejunostomy (the point at which the intestine is joined to the stomach pouch) in 8 patients (8.6%), ulceration in 3 (3.2%), small bowel obstruction in 1 (1.1%), internal hernia in 1 (1.1%), and abdominal wall hernia in1. Importantly, there were no deaths.
Comment
These data show that even in patients older than 60 years, Roux-en-Y gastric bypass surgery (LRYGB) can be performed safely, and can achieve effective weight control. Other studies have shown similar beneficial effects for laparoscopic gastric banding in patients aged 60 years and above. The message is clear: doctors and surgeons considering patients for obesity surgery, should not allow age to be an automatic exclusion criterion.
Trieu HT, Gonzalvo JP, Szomstein S, Rosenthal R. Safety and outcomes of laparoscopic gastric bypass surgery in patients 60 years of age and older. Surg Obes Relat Dis. 2007; 3(3):383-6. Epub 2007 Apr 2.
