1
|
Özdoğan Y, Elibol E, Avlanmış Ö, Çelebi Acungan A. Evaluation of the nutritional status of morbid obesity patients in the first six months after sleeve gastrectomy. NUTR HOSP 2024. [PMID: 39268557 DOI: 10.20960/nh.05243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2024] Open
Abstract
OBJECTIVE in recent years, bariatric surgery has gained popularity as a treatment for obesity worldwide. While patients do experience weight loss after surgery, it is important to be aware that serious nutritional deficiencies may also occur. This study was conducted to evaluate the nutritional status of morbidly obese patients in the first six months after sleeve gastrectomy. METHODS the study was planned as a retrospective study. The data of 76 patients aged 19-64 years who had undergone bariatric surgery and were followed by a dietitian for at least 6 months were included in the study. Preoperative and postoperative biochemical parameters and anthropometric measurements of the patients were taken. RESULTS the lowest body weight of the patients was found at postoperative month 6 (81.74 ± 14.83 kg), the body weight at the preoperative period (115.86 ± 21.28 kg) and postoperative month 1 (100.39 ± 18.28 kg), and the body weight at postoperative month 1 was statistically lower than at the preoperative period. The preoperative body weights and BMI values of the patients were higher than at postoperative months 1 and 6, and the postoperative month 1 values were higher than at postoperative month 6 (p < 0.05). The lowest fasting blood glucose (83.48 ± 8.44 mg/dL), HbA1c (4.96 ± 0.95 %), and Homa-IR (3.34 ± 0.92) were observed at the postoperative month 6. Compared with the preoperative period, the iron level of the patients increased from 69.54 ± 29.82 µg/dL to 96.52 ± 25.39 µg/dL in postoperative month 6, vitamin D levels from 14.48 ± 8.70 µg/dL to 23.96 ± 4.79 µg/dL. While preoperative blood triglyceride and LDL values were statistically higher than in postoperative months 1 and 6, the HDL value was lower (p < 0.05). CONCLUSION as a result, after sleeve gastrectomy, patient body weight decreased, and blood lipid profile and diabetes symptoms improved.
Collapse
Affiliation(s)
- Yahya Özdoğan
- Department of Nutrition and Dietetics. Ankara Yıldırım Beyazıt University
| | - Emine Elibol
- Department of Nutrition and Dietetics. Ankara Yıldırım Beyazıt University
| | | | | |
Collapse
|
2
|
Karpińska I, Dowgiałło-Gornowicz N, Franczak P, Orłowski M, Lech P, Kowalski G, Major P. Factors contributing to weight loss success after bariatric procedures in patient over 65 years old: a multicenter retrospective cohort study. Int J Surg 2024; 110:4893-4899. [PMID: 38729122 PMCID: PMC11325908 DOI: 10.1097/js9.0000000000001588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Although bariatric surgery in patients over 65 years of age gives comparable results to treatment in the younger population, there are still controversies regarding the indications for surgery, risk assessment, and choice between different types of surgery. The study aimed to identify the factors contributing to weight loss success after bariatric surgery in patients over 65 years of age. MATERIAL AND METHODS This is a retrospective, multicenter cohort study of patients with obesity aged over 65 years undergoing primary laparoscopic bariatric surgery in the years 2008-2022. Data came from 11 bariatric centers. Patients were divided into two groups: responders (R) who achieved more than 50% EWL and nonresponders (NR) who achieved less than 50% EWL. Both groups were compared. Uni- and multivariate logistic regression was used to identify predictors of weight loss success. RESULTS Out of 274 analyzed patients, the average BMI before surgery was 42.9 kg/m 2 . The most common obesity-related diseases were hypertension (85.1%) and type 2 diabetes (53.3%). Sleeve gastrectomy was the most frequently performed procedure (85.4%). Uni- and multivariate logistic regression analysis confirmed preoperative BMI (OR=0.9, 95% CI: 0.82-0.98, P =0.02), duration of diabetes >10 years (OR=0.3, 95% CI: 0.09-0.82, P =0.02), balloon placement (OR=10.6, 95% CI: 1.33-84.83, P =0.03), time since first visit (OR=0.9, 95% CI: 0.84-0.99, P =0.04), preoperative weight loss (OR=0.9, 95% CI: 0.86-0.98, P =0.01), and OAGB (OR=15.7, 95% CI: 1.71-143.99, P =0.02) to have a significant impact on weight loss success 1 year after bariatric surgery. CONCLUSIONS Patients with higher preoperative weight loss may have a poorer response to surgery. OAGB emerged as the most beneficial type of surgery in terms of weight loss. Intragastric balloon placement before surgery may be effective in patients above 65 years of age and may be considered as a two-stage approach.
Collapse
Affiliation(s)
- Izabela Karpińska
- 2nd Department of General Surgery, Jagiellonian University Medical College
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Cracow
| | - Natalia Dowgiałło-Gornowicz
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Olsztyn
| | - Paula Franczak
- Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo
| | - Michał Orłowski
- Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo
| | - Paweł Lech
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Olsztyn
| | | | - Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College
| |
Collapse
|
3
|
Santos-Sousa H, Amorim-Cruz F, Nogueiro J, Silva A, Amorim-Cruz I, Ferreira-Santos R, Bouça-Machado R, Pereira A, Resende F, Costa-Pinho A, Preto J, Lima-da-Costa E, Barbosa E, Carneiro S, Sousa-Pinto B. Preoperative risk factors for early postoperative bleeding after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. Langenbecks Arch Surg 2024; 409:163. [PMID: 38775865 PMCID: PMC11111548 DOI: 10.1007/s00423-024-03346-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Although bariatric surgery is an effective intervention for obesity, it comes with risks such as early postoperative bleeding (EPB). Identifying preoperative risk factors for this complication can help patients' risk stratification and optimization. We performed a systematic review and meta-analysis to find predictors for early postoperative bleeding after Roux-en-Y gastric bypass (RYGB). METHODS We conducted a systematic review, searching PubMed, Cochrane Library, and Web of Science until November 2023. We performed a random-effects meta-analysis to explore preoperative risk factors associated with early postoperative bleeding after RYGB. Sources of heterogeneity were explored by leave-one-out analyses. RESULTS 23 studies were included, comprising 232,488 patients. Male gender (meta-analytical RR = 1.42, 95%CI = 1.21-1.66, I2 = 18%, Q Cochran test p-value = 0.29) and revisional surgery (meta-analytical RR = 1.35, 95%CI = 1.12-1.62, I2 = 22%, Q Cochran test p = 0.21) were associated with higher risk of EPB. On average, patients with EPB were older than the remainder (MD for the mean age = 2.82 years, 95%CI = 0.97-4.67, I2 = 0.00%, Q Cochran test p = 0.46). Except for hypertension (meta-analytical RR = 1.33, 95%CI = 1.02-1.73, I2 = 66%, Q Cochran test p < 0.0001), comorbidities were not associated with a higher risk of EPB. CONCLUSION Preoperative risk factors, including age, gender, hypertension, and revisional bariatric surgery, are associated with early postoperative bleeding after RYGB. Further primary studies, with higher methodological quality, are required to detail more risk factors.
Collapse
Affiliation(s)
- Hugo Santos-Sousa
- Obesity Integrated Responsability Unit (CRI-O), São João University Medical Center, Porto, Portugal.
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal.
| | - Filipe Amorim-Cruz
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
| | - Jorge Nogueiro
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
| | - Alexandre Silva
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
| | - Inês Amorim-Cruz
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
| | | | | | - André Pereira
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
| | - Fernando Resende
- Obesity Integrated Responsability Unit (CRI-O), São João University Medical Center, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
| | - André Costa-Pinho
- Obesity Integrated Responsability Unit (CRI-O), São João University Medical Center, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
| | - John Preto
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
| | - Eduardo Lima-da-Costa
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
| | - Elisabete Barbosa
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
- Surgery Department, São João University Medical Center, Porto, Portugal
| | - Silvestre Carneiro
- Obesity Integrated Responsability Unit (CRI-O), São João University Medical Center, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, 4200 - 319, Portugal
| | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, MEDCIDS, University of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| |
Collapse
|
4
|
Dowgiałło-Gornowicz N, Lech P, Katkowski B, Walędziak M, Proczko-Stepaniak M, Szymański M, Karpińska I, Major P. Risk factors for bariatric surgery in patients over 65 years of age-a multicenter retrospective cohort study. Langenbecks Arch Surg 2024; 409:115. [PMID: 38589572 PMCID: PMC11001652 DOI: 10.1007/s00423-024-03304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE Societies are aging, life expectancy is increasing, and as a result, the percentage of elderly people in the population is constantly increasing. When qualifying patients over 65 years of age for bariatric surgery, the benefits and risks should be carefully assessed. Weighing risk factors against each other to improve the quality of life and better control of obesity-related diseases. The study aimed to determine risk factors for bariatric surgery among patients over 65 years of age. METHODS A multicenter, retrospective analysis of patients undergoing laparoscopic bariatric procedures from 2008 to 2022. The patients were divided into two groups: complicated (C) and uncomplicated (UC). Uni- and multivariate logistic regression analysis was performed to obtain significant, independent risk factors. RESULTS There were 20 (7.0%) patients in C group and 264 (93.0%) patients in UC group. The most common complication was intraperitoneal bleeding (8, 2.8). There was no postoperative mortality. The mean follow-up was 47.5 months. In a multivariate logistic regression analysis, length of stay and %EWL significantly corresponded to general complications (OR 1.173, OR 1.020). A higher weight loss before surgery lowered the risk for hemorrhagic events after surgery (OR 0.889). A longer length of stay corresponded to leak after surgery (OR 1.175). CONCLUSIONS Bariatric and metabolic surgery appears to be a safe method of obesity treatment in patients over 65 years of age. The most common complication was intraperitoneal bleeding. A prolonged hospital stay may increase the risk of leakage, while a higher weight loss before the surgery may lower the risk of bleeding.
Collapse
Affiliation(s)
- Natalia Dowgiałło-Gornowicz
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045, Olsztyn, Poland.
| | - Paweł Lech
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045, Olsztyn, Poland
| | - Bartosz Katkowski
- Department of General and Vascular Surgery, Specialist Medical Center, 57-320, Polanica Zdrój, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, 04-141, Warsaw, Poland
| | - Monika Proczko-Stepaniak
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-214, Gdańsk, Poland
| | - Michał Szymański
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-214, Gdańsk, Poland
| | - Izabela Karpińska
- 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688, Cracow, Poland
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688, Cracow, Poland
| |
Collapse
|
5
|
Çalık Başaran N, Marcoviciu D, Dicker D. Metabolic Bariatric surgery in People with Obesity aged ≥65 Years. Eur J Intern Med 2024:S0953-6205(24)00134-1. [PMID: 38556416 DOI: 10.1016/j.ejim.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/13/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Obesity management guidelines recommend metabolic bariatric surgery for individuals with body mass index (BMI) ≥35 kg/m2, regardless of the presence of any obesity-related comorbidity; and for individuals with BMI 30-34.9 kg/m2 with metabolic diseases. Older age is not in itself a contraindication for bariatric surgeries, which can be performed after careful selection and assessment, to decrease the risks of postoperative complications. An essential amount of data has accumulated about bariatric surgery results for persons aged ≥60 years; but data are limited though increasingly accumulating for the ≥65-year-old population. Laparoscopic Roux-en-Y-gastric bypass and sleeve gastrectomy have been the preferred bariatric procedures for older adults with obesity, as for younger patients. This review summarizes the safety and efficacy of bariatric surgery for individuals aged ≥65 years with obesity, and the efforts that have been invested to improve the perioperative and long-term consequences.
Collapse
Affiliation(s)
- Nursel Çalık Başaran
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, General Internal Medicine, Ankara, Türkiye.
| | - Dana Marcoviciu
- Rabin Medical Center, Hasharon Hospital, Department of Internal Medicine D and Obesity Clinic, Petah Tikva, Israel
| | - Dror Dicker
- Rabin Medical Center, Hasharon Hospital, Department of Internal Medicine D and Obesity Clinic, Petah Tikva, Israel; Tel Aviv University, School of Medicine, Tel Aviv, Israel
| |
Collapse
|
6
|
Engin A. Bariatric Surgery in Obesity: Metabolic Quality Analysis and Comparison of Surgical Options. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1460:697-726. [PMID: 39287870 DOI: 10.1007/978-3-031-63657-8_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Obesity is a constantly growing health problem which reduces quality of life and life expectancy. Bariatric surgery (BS) for obesity is considered when all other conservative treatment modalities have failed. Comparison of the multidisciplinary programs with BS regarding to the weight loss showed that substantial and durable weight reduction have been achieved only with bariatric surgical treatments. Although laparoscopic sleeve gastrectomy is the most popular BS, it has high long-term failure rates, and it is claimed that one of every three patients will undergo another bariatric procedure within a 10-year period. Although BS provides weight loss and improvement of metabolic comorbidities, in long-term follow-up, weight gain is observed in half of the patients, while decrease in bone mass and nutritional deficiencies occur in up to 90%. Moreover, despite significant weight loss, several psychological aspects of patients are worsened in comparison to preoperative levels. Nearly one-fifth of postoperative patients with "Loss-of-eating control" meet food addiction criteria. Therefore, the benefits of weight loss following bariatric procedures alone are still debated in terms of the proinflammatory and metabolic profile of obesity.
Collapse
Affiliation(s)
- Atilla Engin
- Faculty of Medicine, Department of General Surgery, Gazi University, Besevler, Ankara, Turkey.
- Mustafa Kemal Mah. 2137. Sok. 8/14, 06520, Cankaya, Ankara, Turkey.
| |
Collapse
|
7
|
Drai C, Chierici A, Schiavo L, Amor IB, Schneider S, Iannelli A. Long-Term Results of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Individuals Older Than 60 Years with Morbid Obesity. Obes Surg 2023; 33:3850-3859. [PMID: 37840091 DOI: 10.1007/s11695-023-06851-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/13/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE An increasing Pnumber of individuals with obesity over the age of 60 years require bariatric surgery to treat obesity and its related medical problems. Sleeve gastrectomy and Roux-en-Y gastric bypass have already proven their efficacy in this population, but literature lacks reports of long-term results. The aim of this study is to compare long-term results of sleeve gastrectomy and Roux-en-Y gastric bypass in individuals older than 60 years old. MATERIALS AND METHODS This is a single-center, retrospective, comparative study of 204 patients undergoing either sleeve gastrectomy (123, 60.3%) or Roux-en-Y gastric bypass (81, 39.7%) for morbid obesity with a mean follow-up of 44.5 ± 19.1 months and 54.6 ± 17.9 months, respectively. RESULTS Total weight loss was significantly increased for patients who underwent Roux-en-Y gastric bypass compared to sleeve gastrectomy from 12 to 48 months after surgery, while no significant difference was found after 60 (30.39% vs. 27.63%) and 72 (27.36% vs. 23.61%) months. Roux-en-Y gastric bypass was associated to a significant increased rate of early postoperative complications (22.2% vs. 4%; p < 0.0001), but no difference was found concerning late postoperative morbidity (6.2% vs. 1.6%). Both procedures were effective in obesity related medical problems. CONCLUSION Roux-en-Y gastric bypass confers an increased weight loss than sleeve gastrectomy in patients over the age of 60 in the mid-term, but it is associated with more early postoperative complications. Sleeve gastrectomy can be considered a valid alternative as long-term weight loss results are superposable to those ensured by Roux-en-Y gastric bypass.
Collapse
Affiliation(s)
- Céline Drai
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, France
- Université Côte d'Azur, Nice, France
| | - Andrea Chierici
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, France
| | - Luigi Schiavo
- Unit of General and Emergency Surgery, University Hospital San Giovanni Di Dio E Ruggi d'Aragona, Mercato San Severino, Salerno, Italy
| | - Imed Ben Amor
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, France
| | - Stéphane Schneider
- Université Côte d'Azur, Nice, France
- Department of Gastroenterology and Clinical Nutrition, CHU de Nice, University Côte d'Azur, Nice, France
| | - Antonio Iannelli
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, France.
- Université Côte d'Azur, Nice, France.
- Inserm, U1065, Team 8 "Hepatic Complications of Obesity and Alcohol", Nice, France.
| |
Collapse
|
8
|
Delcarro A, Zanoni AAG, Ciccarese F, Oldani A, Villa R, Airoldi C, Olmi S. Laparoscopic Sleeve Gastrectomy in Patients Over 60 Years Old: A Long-Term Follow-Up. J Laparoendosc Adv Surg Tech A 2023; 33:1033-1039. [PMID: 37579046 DOI: 10.1089/lap.2023.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Purpose: This study analyzed the safety and effectiveness of laparoscopic sleeve gastrectomy (LSG) in patients over 60 years old, in a long-term follow-up, in a high-volume bariatric center. Methods: We retrospectively analyzed all patients older than 60 years who underwent LSG in our center from January 2009 to December 2018. A prospectively collected database of 4991 consecutive LSG cases was reviewed. Results: One hundred seventy-nine sleeve gastrectomy procedures were performed in patients older than 60 years, 135 were aged 60-65 years (group A) and 44 were older than 65 years (group B). We reported five cases (2.7%) of early complications: three postoperative hemorrhages, one cardial leakage, and one perigastric abscess. No thromboembolic events or mortality rates were reported. The mean follow-up period was 5.5 years (66 months). The follow-up loss rate was about 29%. At last follow-up, the mean body-mass index/body mass/percentage of excess weight loss values were, respectively, 33.7 ± 7/86.1 ± 21/60.4 ± 28.6 in group A and 32.4 ± 6.4/82.6 ± 18/61.8 ± 33 in group B. We reported 5 (4.0%) trocar site hernias, 1 (0.8%) cardial junction stenosis, and 22 (18%) new outbreaks of gastroesophageal reflux (GERD). There were 7 reinterventions (5.7%): 5 for weight regain and 2 for GERD not responding to medical therapy. There were no statistically significant differences between the two age groups. Conclusions: LSG is a safe and effective treatment for severe obesity in people over 60 years old. There are no differences in results of patients over 65 years and between 60 and 65 years old. Scales that include associated medical problems and the patient's general condition must be considered.
Collapse
Affiliation(s)
| | | | | | - Alberto Oldani
- Department of General Surgery, Policlinico San Marco, Osio Sotto, Italy
| | - Roberta Villa
- Department of General Surgery, Policlinico San Marco, Osio Sotto, Italy
| | - Chiara Airoldi
- Department of Statistics, University of Eastern Piedmont, Novara, Italy
| | - Stefano Olmi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
9
|
Felsenreich DM, Malzner A, Eichner M, Hoelbing E, Moosbrugger A, Beckerhinn P, Prager G, Brix JM, Itariu BK. [Indications and preoperative planning for bariatric surgery]. Wien Klin Wochenschr 2023; 135:721-728. [PMID: 37821695 PMCID: PMC10567874 DOI: 10.1007/s00508-023-02271-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 10/13/2023]
Abstract
These clinical practice guidelines represent the consensus opinion of a group of Austrian specialist physicians associated with the treatment of obesity. The recommendations incorporate the current literature and guidelines and aim to balance both procedural feasibility and patient acceptance and adherence. Special emphasis was placed on simplification of the preoperative clarification and maximum patient safety. Therefore, this article makes no claim to be complete in all fields.
Collapse
Affiliation(s)
- Daniel Moritz Felsenreich
- Klinische Abteilung für Viszeralchirurgie, Universitätsklinik für Allgemeinchirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Andrea Malzner
- Abteilung für Innere Medizin I, Gastroenterologie und Hepatologie, Rheumatologie, Endokrinologie und Diabetologie, Klinikum Wels-Grieskirchen, Wels, Österreich
| | - Marlies Eichner
- 3. Medizinische Abteilung mit Stoffwechselerkrankungen und Nephrologie, Klinik Hietzing, Wien, Österreich
| | | | - Alexander Moosbrugger
- Abteilung für Innere Medizin II, Krankenhaus der Barmherzigen Brüder, Graz, Österreich
| | - Philipp Beckerhinn
- Abteilung für Chirurgie, Landesklinikum Hollabrunn, Hollabrunn, Österreich
| | - Gerhard Prager
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Johanna Maria Brix
- 1. Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
- Karl Landsteiner Institut für Adipositas und Stoffwechselerkrankungen, Klinik Landstraße, Wien, Österreich
| | - Bianca-Karla Itariu
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| |
Collapse
|
10
|
Hany M, Ibrahim M, Zidan A, Agayaby ASS, Aboelsoud MR, Gaballah M, Torensma B. Two-Year Results of the Banded Versus Non-banded Re-sleeve Gastrectomy as a Secondary Weight Loss Procedure After the Failure of Primary Sleeve Gastrectomy: a Randomized Controlled Trial. Obes Surg 2023; 33:2049-2063. [PMID: 37156932 PMCID: PMC10166688 DOI: 10.1007/s11695-023-06598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Insufficient weight loss or weight regain has been reported in up to 30% of patients after laparoscopic sleeve gastrectomy (LSG). Approximately 4.5% of patients who undergo LSG need revisional surgery for a dilated sleeve. METHODS This randomized controlled trial compared the outcomes between banded (BLSG) and non-banded re-LSG (NBLSG) after weight regain. Percentage excess body weight loss (%EWL), percentage total weight loss (%TWL), associated medical problems, gastric volume measurement, and endoscopy were measured preoperatively and 1 and 2 years postoperatively. RESULTS Both groups (25 patients each) achieved similar % EWL and %TWL at six months, one year, and two years postoperatively (%EWL 46.9 vs. 43.6, 83.7 vs. 86.3, and 85.7 vs. 83.9) (p= > 0.151) (%TWL 23.9 vs. 21.8, 43.1 vs .43.3, 44.2 vs. 42.2) (p=>0.342), respectively. However, the body mass index was significantly lower with BLSG (24.9 vs. NBLSG, 26.9). Both groups showed a significant reduction in stomach volume after two years (BLSG -248.4 mL vs. NBLSG -215.8 mL). Food tolerance (FT) scores were significantly reduced in both groups, whereby BSLG had significantly lower FT with an average of -1.1 point. No significant differences were observed regarding improvement of the associated medical problems after the first and two years after revisional LSG or the postoperative complications between both groups. CONCLUSION Laparoscopic re-LSG is feasible and safe with satisfactory outcomes in patients with weight regain after LSG who have gastric dilatation without reflux esophagitis. Both groups had comparable significant weight loss effects and improvement of associated medical problems. The BLSG tends to have a more stable weight loss after two years with a significantly lower BMI, lower stomach volume, and less weight regain. Food tolerance decreased in both groups but reduced more in the BLSG group. After a 2-year follow-up, we may regard both procedures are safe, with no significant differences in the occurrence of complications and nutritional deficits.
Collapse
Affiliation(s)
- Mohamed Hany
- Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt.
- Madina Women's Hospital, Alexandria, Egypt.
| | - Mohamed Ibrahim
- Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt
| | - Ahmed Zidan
- Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt
| | - Ann Samy Shafiq Agayaby
- Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt
| | - Moustafa R Aboelsoud
- Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt
| | - Muhammad Gaballah
- Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561, Egypt
| | - Bart Torensma
- Leiden University Medical Center (LUMC), Leiden, The Netherlands
| |
Collapse
|
11
|
Pfefferkorn U, Hort S, Beluli M, La Vista M, Züger T. Weight Loss After Bariatric Surgery in Different Age Groups. Obes Surg 2023; 33:1154-1159. [PMID: 36757647 DOI: 10.1007/s11695-023-06488-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Weight loss after bariatric operations may be reduced in older patients due to changes in metabolism. Some studies showed inferior weight loss in older patients compared to younger ones while others showed no such difference. In order to counsel patients about the expected weight loss after bariatric surgery, recommendations stratified by age are important. METHODS This study encompasses a retrospective analysis of 500 consecutive patients with RYGB or sleeve gastrectomies from a single institution with a mean follow-up time of 3.6 years. Patients were stratified into five groups according to age at the time point of the operation: < 30 years, 30-39 years, 40-49 years, 50-59 years, and ≥ 60 years. RESULTS Weight loss expressed in percent excessive body mass index loss (%EBMIL) at nadir were 86.6, 89.5, 84.0, 77.9, and 76.4% and 75.6, 78.4, 73.3, 68.0, and 69.0% at the time of last follow-up for the five groups, respectively. Weight loss was significantly higher in younger patients than in older patients for both time points. The total number of comorbidities that showed complete remission (normal values without treatment), was also significantly higher in the younger age groups. CONCLUSIONS Primary bariatric operations yield better weight loss results and remission rates of obesity related comorbidities in younger patients, but are still effective in older individuals.
Collapse
Affiliation(s)
- Urs Pfefferkorn
- Department of Surgery, Kantonsspital Olten, Baslerstrasse 150, 4600, Olten, Switzerland.
| | - Sabrina Hort
- Department of Surgery, Kantonsspital Baden, 5404, Baden, Switzerland
| | - Melika Beluli
- Department of Surgery, Kantonsspital Olten, Baslerstrasse 150, 4600, Olten, Switzerland
| | - Monica La Vista
- Department of Endocrinology, Diabetes and Metabolic Diseases, Kantonsspital Olten, 4600, Olten, Switzerland
| | - Thomas Züger
- Department of Endocrinology, Diabetes and Metabolic Diseases, Kantonsspital Olten, 4600, Olten, Switzerland
| |
Collapse
|
12
|
Varvoglis DN, Lipman JN, Li L, Sanchez-Casalongue M, Zhou R, Duke MC, Farrell TM. Gastric Bypass Versus Sleeve Gastrectomy: Comparison of Patient Outcomes, Satisfaction, and Quality of Life in a Single-Center Experience. J Laparoendosc Adv Surg Tech A 2023; 33:155-161. [PMID: 36106945 DOI: 10.1089/lap.2022.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Laparoscopic sleeve gastrectomy (LSG) is the most common primary bariatric operation performed in the United States. Its relative technical ease, combined with a decreased risk for anatomic and malabsorptive complications make LSG an attractive option compared to laparoscopic gastric bypass (LGB) for many patients and surgeons. However, emerging evidence for progressive gastroesophageal reflux disease (GERD) after LSG, and the inferior weight loss in many studies, suggests that the enthusiasm for LSG requires reassessment. We hypothesized that patient satisfaction and quality of life (QoL) may be lower after LSG compared to LGB because of these differences. Methods: We distributed a survey querying weight-loss outcomes, complications, foregut symptoms, QoL, and overall satisfaction to patients who underwent bariatric operations at our institution between 2000 and 2020 and who had electronic mail contact information available. Mean follow-up was 2.75 ± 2.41 years for LGB patients and 3.37 ± 2.18 (P = .021) years for LSG patients. We compared these groups for weight-loss outcomes, changes in foregut symptoms, gastrointestinal QoL, postbariatric QoL, and overall satisfaction using appropriate statistical tests. Results: Among 323 respondents, 126 underwent LGB and 197 underwent LSG. LGB patients had larger body mass index (BMI) reduction than LSG patients (-17.16 ± 9.07 kg/m2 versus -14.87 ± 7.4 kg/m2, P = .023). LGB patients reported less reflux (P = .003), with decreased heartburn (P < .0001) and regurgitation (P = .0027). However, a greater proportion of LGB patients reported at least one complication (P = .025). Despite this, more LGB patients reported satisfaction (92.86%) than LSG patients (73.6%). Conclusion: LGB patients are significantly more likely to be satisfied than LSG patients. Factors contributing to the higher level of satisfaction include less GERD and better BMI decrease.
Collapse
Affiliation(s)
- Dimitrios N Varvoglis
- Department of Surgery and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffrey N Lipman
- Department of Surgery and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lang Li
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Manuel Sanchez-Casalongue
- Department of Surgery and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Randal Zhou
- Department of Surgery, Yale University, New Haven, Connecticut, USA
| | - Meredith C Duke
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Timothy M Farrell
- Department of Surgery and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
13
|
One Anastomosis Gastric Bypass Compared with Sleeve Gastrectomy in Elderly Patients: Safety and Long-term Outcomes. Obes Surg 2023; 33:570-576. [PMID: 36547857 DOI: 10.1007/s11695-022-06421-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/07/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND As life expectancy increases, more elderly patients are being considered for metabolic bariatric surgery. We aimed to assess the safety and long-term effectiveness of one anastomosis gastric bypass (OAGB) compared to sleeve gastrectomy (SG). METHODS Single-center retrospective comparative study of OAGB and SG (2012-2019) in patients aged ≥ 65 years. RESULTS In all, 124 patients underwent OAGB (n = 41) and SG (n = 83). Mean age was 67.6 ± 2.8 and 67.6 ± 2.6 years (p = 0.89), respectively. Baseline characteristics were comparable, except lower rates of hypertension (HTN) and non-alcoholic fatty liver disease in OAGB than SG patients (43.9% vs. 74.6%; p < 0.001, and 39.0% vs. 89.1%; p < 0.001, respectively). Body mass index (BMI) of OAGB and SG patients decreased from 41.8 ± 7.8 and 43.3 ± 5.9 kg/m2 (p = 0.25) to 28.6 ± 4.7 and 33.2 ± 5.3 (p < 0.001), at long-term follow-up, respectively. Excess weight loss (EWL) > 50% was achieved in 80.6% and 43.2% of OAGB and SG patients, with a mean EWL of 67.2% ± 22.3 and 45.8% ± 18.0 (p < 0.001) and a mean total weight loss (TWL) of 30.7% ± 10.4 and 21.9% ± 8.1 (p < 0.001), respectively. Resolution rates of obesity-associated medical problems were similar, except type 2 diabetes (T2D) and HTN, which were 86.6% and 73.3% in OAGB, compared with 29.7% and 36.3% in SG patients (p < 0.001 and p = 0.001), respectively. Major early complication rates were comparable (2.4% vs. 3.6%; p = 0.73, respectively). Revision for late complications was required in two OAGB patients. CONCLUSIONS OAGB in the elderly is safe and results in better long-term weight reduction and resolution of T2D and HTN than SG.
Collapse
|
14
|
Hany M, Torensma B, Zidan A, Agayby ASS, Ibrahim M, Shafie ME, Sayed IE. Comparison of Sleeve Volume Between Banded and Non-banded Sleeve Gastrectomy: Midterm Effect on Weight and Food Tolerance-a Retrospective Study. Obes Surg 2023; 33:406-417. [PMID: 36508154 PMCID: PMC9889434 DOI: 10.1007/s11695-022-06404-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/24/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sleeve dilatation after laparoscopic sleeve gastrectomy (LSG) causes weight regain (WR). Banded sleeve gastrectomy (BSG) was proposed to prevent dilatation and reduce WR. METHODS A retrospective cohort study on patients who underwent BSG and LSG and completed 4 years of follow-up from 2016 to 2021 was included. Body mass index (BMI), percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL), and FT scores were calculated at 1, 2, 3, and 4 years. The sleeve volume was estimated at 6 months, 1 year, and 4 years. Multi-variate analysis was conducted to assess correlations between covariates. WR was calculated as weight gain > 10%, > 10 kg above the nadir, or BMI increase of ≥ 5 kg/m 2 above the nadir. RESULTS This study included LSG 1279 patients and BSG 132 patients. Mean %EWL at 1 year was 83.87 ± 17.25% in LSG vs. 85.71 ± 7.92% in BSG and was 83.47 ± 18.87% in LSG and 85.54 ± 7.48% in BSG at 4 years. Both had significant weight loss over time (p. < 0.001) with no significant main effect of surgery (p.0.438). Mean sleeve volume at 6 months was 102.32 ± 9.88 ± 10.28 ml in LSG vs. 101.89 ± 10.019 ml in BSG and at 4 years was 580.25 ± 112.25 ml in LSG vs. 157.94 ± 12.54 ml in BSG (p. < 0.001). WR occurred in 136 (10.6%) and 4 (3.1%) (p.0.002) in LSG and BSG patients, 90 (7%) vs. zero (0%) (p.0.002) and 31 (2.4%) vs. zero (0%) (p.0.07) using the > 10%, > 10 kg increase above the nadir and the ≥ 5 kg/m 2 BMI increases above the nadir formulas, respectively. CONCLUSION BSG had significantly lower sleeve volume, significantly lower WR, and significantly lower FT scores than LSG after 4 years from surgery; however, volume changes were not correlated with weight loss.
Collapse
Affiliation(s)
- Mohamed Hany
- grid.7155.60000 0001 2260 6941Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561 Egypt ,Consultant of Bariatric Surgery at Madina Women’s Hospital (IFSO Center of Excellence), Alexandria, Egypt
| | - Bart Torensma
- grid.10419.3d0000000089452978Clinical Epidemiologist, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Ahmed Zidan
- grid.7155.60000 0001 2260 6941Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561 Egypt
| | - Ann Samy Shafiq Agayby
- grid.7155.60000 0001 2260 6941Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561 Egypt
| | - Mohamed Ibrahim
- grid.7155.60000 0001 2260 6941Department of Surgery, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara, Alexandria, 21561 Egypt
| | - Mohamed El Shafie
- grid.7155.60000 0001 2260 6941Department of Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman El Sayed
- grid.7155.60000 0001 2260 6941Biomedical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| |
Collapse
|
15
|
Alghamdi S, Mirghani H, Alhazmi K, Alatawi AM, Brnawi H, Alrasheed T, Badoghaish W. Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy effects on obesity comorbidities: A systematic review and meta-analysis. Front Surg 2022; 9:953804. [PMID: 36532129 PMCID: PMC9755332 DOI: 10.3389/fsurg.2022.953804] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/17/2022] [Indexed: 07/20/2023] Open
Abstract
Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used bariatric procedures. There is an increasing awareness about a comorbidity-based indication for bariatric surgery regardless of weight (metabolic surgery). The best operation to mitigate obesity-associated comorbidities is a matter of controversy. This review is aimed at comparing LRYGB and LSG for the treatment of diabetes, hypertension, dyslipidemias, obstructive sleep apnea (OSA), and gastroesophageal reflux (GERD). We searched PubMed, MEDLINE, SCOPUS, Web of Science, and Cochrane library for articles comparing these two commonly used bariatric approaches. We identified 2,457 studies, 1,468 of which stood after the removal of duplications; from them, 81 full texts were screened and only 16 studies were included in the final meta-analysis. LRYGB was equal weight to LSG for diabetes (P-value = 0.10, odd ratio, 1.24, 95% CI, 0.96-1.61, I 2 for heterogeneity = 30%, P-value for heterogeneity, 0.14), and OSA (P-value = 0.38, odd ratio, 0.79, 95% CI, 0.47-1.33, I 2 for heterogeneity = 0.0%, P-value for heterogeneity, 0.98). However, LRYGB was superior to LSG regarding hypertension (P-value = 0.009, odd ratio, 1.55, 95% CI, 1.20-2.0, I 2 for heterogeneity = 0.0%, P-value for heterogeneity, 0.59), dyslipidemia (odd ratio, 2.18, 95% CI, 1.15-4.16, P-value for overall effect, 0.02), and GERD (P-value = 0.003, odd ratio, 3.16, 95% CI, 1.48-6.76). LRYGB was superior to LSG for gastroesophageal reflux, hypertension, and dyslipidemia remission. While the two procedures were equal regarding diabetes and obstructive sleep, further reviews comparing LSG, and one anastomosis gastric bypass are recommended.
Collapse
Affiliation(s)
- Salah Alghamdi
- Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Hyder Mirghani
- Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Khalid Alhazmi
- Department of Pathology, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Amirah M. Alatawi
- Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Haneen Brnawi
- Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Tariq Alrasheed
- Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Waleed Badoghaish
- Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| |
Collapse
|
16
|
Quintero JHR, Grosser R, Velez GR, Ramos-Santillan VO, Pereira X, Flores FM, Choi J, Moran-Atkin E, Camacho D, Lima DL. Safety and efficacy of roux-en-y gastric bypass in older aged patients. Rev Col Bras Cir 2022; 49:e20223332. [PMID: 36197347 PMCID: PMC10578815 DOI: 10.1590/0100-6991e-20223332-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION laparoscopic Roux-en-Y Gastric Bypass (LRYGB) has been a revolutionary intervention for weight loss with reduction of up to 60-70% of excess body weight. However, these outcomes are not as well validated at the extremes of age, where the safety of the intervention still has some caveats. The aim of this study is to assess the efficacy and safety of primary LRYGB among different age groups. METHODS the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried for patients who underwent primary LRYGB from January 2014 to December 2017 at a single institution. Four groups were created and compared by dividing our sample by age quartiles. The primary outcome was percent excess weight loss (%EWL) at 1 year. Additional operative outcomes and complications were also compared across groups. RESULTS a total of 1013 patients underwent non-revisional LRYGB during the study period. Mean %EWL at one year was 55%. When compared between quartiles, there was a statistically significant difference in %EWL: 1st 62%, 2nd 57%, 3rd 54% and 4th 47% (p=0.010). The differences in the secondary outcomes between age groups did not demonstrate statistical significance. CONCLUSIONS though patients in the fourth age quartile (range) did not demonstrate a statistically significant increase in adverse outcomes, they did lose less weight compared to other cohorts. The %EWL at one year after RYGB varied by age in our cohort. Goals after bariatric surgery should be individualized as weight loss is less robust with aging.
Collapse
Affiliation(s)
| | - Rachel Grosser
- - Montefiore Medical Center, Surgery - The Bronx - New York - Estados Unidos
| | | | | | - Xavier Pereira
- - Montefiore Medical Center, Surgery - The Bronx - New York - Estados Unidos
| | | | - Jenny Choi
- - Montefiore Medical Center, Surgery - The Bronx - New York - Estados Unidos
| | - Erin Moran-Atkin
- - Montefiore Medical Center, Surgery - The Bronx - New York - Estados Unidos
| | - Diego Camacho
- - Montefiore Medical Center, Surgery - The Bronx - New York - Estados Unidos
| | | |
Collapse
|
17
|
Revisional Roux-en-Y Gastric Bypass Versus Revisional One-Anastomosis Gastric Bypass After Failed Sleeve Gastrectomy: a Randomized Controlled Trial. Obes Surg 2022; 32:3491-3503. [PMID: 36098907 PMCID: PMC9469810 DOI: 10.1007/s11695-022-06266-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022]
Abstract
Background
High rates of revision surgery have been reported for laparoscopic sleeve gastrectomy (LSG), with weight regain (WR) as the most frequently reported cause. Roux-en-Y gastric bypass (RYGB) is the most commonly performed revision procedure, whereas one-anastomosis gastric bypass (OAGB) is a less popular approach. Methods A single-blinded randomized controlled trial was conducted. One hundred seventy-six patients were enrolled and randomized. After loss to follow-up, 80 patients for RYGB and 80 patients for OAGB were analyzed, with a 2-year follow-up. Patients with grade B or higher gastroesophageal reflux disease (GERD) were excluded. Early and late postoperative complications were recorded. Body mass index (BMI), percentage of excess BMI loss (%EBMIL), nutritional laboratory test results, and the resolution of associated medical problems were assessed after revision surgery. Results After 2 years, both groups achieved significantly lower BMI than their post-LSG nadir BMI (p < 0.001). The %EBMIL changes showed significantly faster weight loss in the OAGB group than in the RYGB at the 6-month follow-up (mean difference: 8.5%, 95% confidence interval [CI]: 0.2 to 16.9%). However, at 1-year and 2-year follow-ups, the differences were statistically insignificant (p > 0.05). Early and late complications were similar between two groups. Both groups showed improvement or resolution of associated medical problems, with no statistically significant differences after 2 years (p = 1.00). Conclusion Both revisional RYGB and OAGB have comparable significant weight loss effects when performed for WR after LSG. After a 2-year follow-up, both procedures were safe, with no significant differences in the occurrence of complications and nutritional deficits. Graphical abstract ![]()
Collapse
|
18
|
Pereira AF, Santa-Cruz F, Coutinho LR, Vieira-DE-Melo MCPT, Hinrichsen EA, Siqueira LT, Figueiredo JL, Ferraz ÁAB. Impact of bariatric surgery in elderly patients with obesity. Rev Col Bras Cir 2022; 49:e20223299. [PMID: 35858036 PMCID: PMC10578788 DOI: 10.1590/0100-6991e-20223299-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/30/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION to evaluate the long-term impact of bariatric surgery in the elderly population. METHODS a retrospective study including all patients older than 60 years who underwent Roux-en-Y gastric bypass (RYGB) at our center and maintained a follow-up longer than 1 year. Clinical and laboratory variables were studied to assess remission of obesity and its comorbidities, as well as variables directly related to the surgical procedure itself, including early and late complications. RESULTS fifty-six patients were studied, mostly female (76,8%), with a mean age of 64.02 ± 3.34. A rate of complications of 37,5% was observed, with 10,7% requiring hospital admission and emergency surgery. The mean excess weight loss (%EWL) was 74.22% ± 26.76. The remission rates of hypertension and diabetes mellitus were 26.08% and 54.54%, respectively. There was significant difference in BMI reduction (12.25 ± 5.42, p<0.001), total cholesterol (31.37 ± 38.89 p<0,001), LDL cholesterol (23.45 ± 34.9, p=0.002), HDL cholesterol (5.14 ± 11.13, p=0,024), triglycerides (48.85 ± 56.15 p<0.001), HbA1C (1,81 ± 1,97, p<0,001) e PCR (1.43 ± 1.96, p<0.001). CONCLUSION bariatric surgery was effective in weight loss and remission of comorbidities in the elderly obese population within the long term.
Collapse
Affiliation(s)
- Adriano F Pereira
- - Universidade Federal de Pernambuco, Pós-Graduação em Cirurgia - Recife - PE - Brasil
| | - Fernando Santa-Cruz
- - Universidade Federal de Pernambuco, Pós-Graduação em Cirurgia - Recife - PE - Brasil
| | - Lucas R Coutinho
- - Universidade Federal de Pernambuco, Curso de Medicina - Recife - PE - Brasil
| | | | - Eduarda A Hinrichsen
- - Hospital Getúlio Vargas, Programa de Residência Médica em Cirurgia Geral - Recife - PE - Brasil
| | - Luciana T Siqueira
- - Universidade Federal de Pernambuco, Departamento de Cirurgia - Recife - PE - Brasil
| | - José-Luiz Figueiredo
- - Universidade Federal de Pernambuco, Departamento de Cirurgia - Recife - PE - Brasil
| | - Álvaro A B Ferraz
- - Universidade Federal de Pernambuco, Departamento de Cirurgia - Recife - PE - Brasil
| |
Collapse
|
19
|
Lo Menzo E. Comment on: Bariatric Surgery Outcomes in Geriatric Patients: A Contemporary, Nationwide Analysis. Surg Obes Relat Dis 2022; 18:1012-1014. [DOI: 10.1016/j.soard.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/14/2022] [Indexed: 11/16/2022]
|
20
|
Mabeza RM, Mao Y, Maynard K, Lee C, Benharash P, Yetasook A. Bariatric Surgery Outcomes in Geriatric Patients: A Contemporary, Nationwide Analysis. Surg Obes Relat Dis 2022; 18:1005-1011. [DOI: 10.1016/j.soard.2022.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/02/2022] [Accepted: 04/17/2022] [Indexed: 12/13/2022]
|
21
|
Safety and Efficacy of One Anastomosis Gastric Bypass on Patients with Severe Obesity Aged 65 Years and Above. Obes Surg 2022; 32:1610-1616. [PMID: 35277792 DOI: 10.1007/s11695-022-05994-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE With the global increase in life expectancy and the subsequent impaired quality of life in older obese adults, modalities such as bariatric surgery become crucial to help lose excess weight. This study was conducted to evaluate the effectiveness and safety of one anastomosis gastric bypass (OAGB) in patients 65 years old and above. MATERIALS AND METHODS This retrospective cohort study was conducted on 61 patients with severe obesity aged ≥ 65 years through Iran National Obesity Surgery Database. The patients had undergone OAGB and were followed up for 12 to 60 months. The required data was extracted through national database. RESULTS Mean age and BMI of the patients were 67.62 ± 2.03 years and 46.42 ± 5.46 kg/m2, respectively. Regarding gender, 90.1% of the participants were female. Mean operative time and length of hospital stay were 41.37 ± 13.91 min and 1.16 ± 0.61 days, respectively. Five patients (8.19%) required ICU admission. The changes in %TWL after 3, 6, 12, 24, 36, 48, and 60 month follow-up was 18.62%, 25.51%, 32.84%, 35.86%, 38.49%, 31.41%, and 29.52%, respectively. The resolution of gastroesophageal reflux disease, diabetes mellitus, dyslipidemia, obstructive sleep apnea, and hypertension after 24 month was about 100%, 65%, 73.33%, 100%, and 76%, respectively. The postoperative early and late complications were 6.53% and 11.46%, respectively. We did not find significant difference in above results between two age groups of 65-70 and > 70 years. CONCLUSIONS OAGB can be a good choice in older obese adults because of its shorter operative time, higher potency, and low complication rate.
Collapse
|
22
|
QUINTERO JORGEHUMBERTORODRIGUEZ, GROSSER RACHEL, VELEZ GUSTAVOROMERO, RAMOS-SANTILLAN VICENTEOMAR, PEREIRA XAVIER, FLORES FERNANDOMUÑOZ, CHOI JENNY, MORAN-ATKIN ERIN, CAMACHO DIEGO, LIMA DIEGOLAURENTINO. Segurança e eficácia do bypas gástrico em Y de Roux em pacientes idosos. Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Introdução: o Bypass Gástrico Laparoscópico em Y de Roux (LRYGB) tem sido uma intervenção revolucionária para perda de peso com redução de até 60-70% do excesso de peso corporal. No entanto, esses resultados não são tão bem validados nos extremos de idade, onde a segurança da intervenção ainda possui algumas ressalvas. O objetivo deste estudo é avaliar a eficácia e segurança do LRYGB entre diferentes faixas etárias. Métodos: O banco de dados do Programa de Acreditação e Melhoria da Qualidade da Cirurgia Metabólica e Bariátrica (MBSAQIP) foi consultado para pacientes submetidos a LRYGB de janeiro de 2014 a dezembro de 2017 em uma única instituição. Quatro grupos foram criados e comparados dividindo a amostra por quartis de idade. O desfecho primário foi perda percentual de excesso de peso (%EWL) em 1 ano. Resultados: 1013 pacientes foram submetidos a LRYGB durante o período do estudo. A média de %EWL em um ano foi de 55%. Quando comparados entre os quartis, houve diferença significante no %EWL: 1º 62%, 2º 57%, 3º 54%, e 4º 47% (p=0,010). As diferenças nos desfechos secundários entre as faixas etárias não demonstraram significância estatística. Conclusões: embora os pacientes no quarto quartil de idade não tenham demonstrado um aumento estatisticamente significativo nos resultados adversos, eles perderam menos peso em comparação com outras coortes. O %EWL um ano após RYGB variou de acordo com a idade em nossa coorte. Os objetivos após a cirurgia bariátrica devem ser individualizados, pois a perda de peso é menos robusta com o envelhecimento.
Collapse
Affiliation(s)
| | | | | | | | | | | | - JENNY CHOI
- Montefiore Medical Center, Estados Unidos
| | | | | | | |
Collapse
|
23
|
PEREIRA ADRIANOF, SANTA-CRUZ FERNANDO, COUTINHO LUCASR, VIEIRA-DE-MELO MARIACLARAPT, HINRICHSEN EDUARDAA, SIQUEIRA LUCIANAT, FIGUEIREDO JOSÉLUIZ, FERRAZ ÁLVAROAB. Impacto da cirurgia bariátrica em pacientes idosos portadores de obesidade. Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Introdução: avaliar o impacto da cirurgia bariátrica na população idosa no longo prazo. Métodos: estudo retrospectivo que incluiu todos os pacientes com mais de 60 anos submetidos ao Bypass gástrico em Y de Roux (BGYR) em nosso centro e que mantiveram seguimento superior a 1 ano. Foram estudadas variáveis clínicas e laboratoriais para avaliação da remissão da obesidade e suas comorbidades, além de variáveis diretamente relacionados ao procedimento cirúrgico em si, incluindo complicações precoces e tardias. Resultados: foram estudados 56 pacientes, a maioria do sexo feminino (76,8%), com idade média de 64,02 ± 3,34. Foi observada uma taxa de complicações de 37,5%, com 10,7% requerendo internamento hospitalar e cirurgia de urgência. A média geral da perda do excesso de peso (%PEP) foi de 74,22% ± 26,76. As taxas de remissão de hipertensão e diabetes mellitus foram de 26,08% e 54,54%, respectivamente. Houve variação significativa no IMC (12,25 ± 5,42, p<0,001), colesterol total (31,37 ± 38,89 p<0,001), colesterol LDL (23,45 ± 34,9, p=0,002), colesterol HDL (5,14 ± 11,13, p=0,024), triglicerídeos (48,85 ± 56,15 p<0,001), HbA1C (1,81 ± 1,97, p<0,001) e PCR (1,43 ± 1,96, p<0,001). Conclusão: a cirurgia bariátrica se mostrou eficaz na perda de peso e na remissão de comorbidades na população de idosos com obesidade no longo prazo..
Collapse
|
24
|
Is laparoscopic bariatric surgery as safe and effective before and after age 60? Results from a propensity-score analysis. Surg Obes Relat Dis 2021; 18:520-529. [DOI: 10.1016/j.soard.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 11/11/2021] [Accepted: 12/12/2021] [Indexed: 12/17/2022]
|
25
|
Edwards MA, Coombs S, Spaulding A. Racial disparity in causes for readmission following bariatric surgery. Surg Obes Relat Dis 2021; 18:241-252. [PMID: 34863671 DOI: 10.1016/j.soard.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/14/2021] [Accepted: 10/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Readmission after bariatric surgery is not cost-effective and is a preventable quality metric within standardized practices. However, reasons for readmission among racial/ethnic bariatric cohorts are less explored and understood. OBJECTIVE Our study objective was designed to compare reasons for readmission among racial/ethnic cohorts of bariatric patients. SETTING Academic hospital. METHODS We performed a retrospective analysis of the 2015-2018 MBSAQIP databases to identify Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) cases. Regression analyses determined predictors of all-cause and bariatric-related readmissions. Reasons for readmission were compared between racial/ethnic cohorts using propensity score matching. RESULTS More than 550 000 RYGB and SG cases were analyzed. The readmission rate was 3%-4%. Black race, RYGB, robot-assisted approach, and numerous co-morbidities were independently associated with readmission (P <.05). In RYGB cases, black (versus white) patients were at decreased odds of leak-related (P < .001) and cardiovascular-related (P < .001) readmissions but at increased odds of readmissions related to renal complications (P < .001). Hispanic (versus white) patients had a higher likelihood of venous thromboembolism-related readmissions (P < .001). In SG cases, black (versus white) patients had a similar lower likelihood of readmission related to leaks or cardiovascular complications but higher odds of readmission related to renal complications (P < .001). Hispanic (versus black) patients had a higher likelihood of leak-related readmissions (P < .001). CONCLUSION Readmission reasons after bariatric surgery vary by race/ethnicity. Perioperative pathways to mitigate complications, including readmissions, should consider these disparate findings.
Collapse
Affiliation(s)
| | - Shannon Coombs
- Alix School of Medicine, Mayo Clinic, Jacksonville, Florida
| | - Aaron Spaulding
- Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, Florida
| |
Collapse
|
26
|
Edwards MA, Agarwal S, Mazzei M. Racial disparities in bariatric perioperative outcomes among the elderly. Surg Obes Relat Dis 2021; 18:62-70. [PMID: 34688570 DOI: 10.1016/j.soard.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/18/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Bariatric surgery outcomes in elderly patients have been shown to be safe, but with a higher rate of adverse outcomes compared with nonelderly patients. The impact of race on bariatric surgery outcomes continues to be explored, with recent studies showing higher rates of adverse outcomes in black patients. Perioperative outcomes in racial cohorts of elderly bariatric patients are largely unexplored. OBJECTIVE The goal of this study was to compare outcomes between elderly non-Hispanic black (NHB) and non-Hispanic white (NHW) bariatric surgery patients to determine whether outcomes are mediated by race. SETTING Academic hospital. METHODS Patients who had a primary Roux-en-Y (RYGB) and sleeve gastrectomy (SG) in the period 2015-2018 and were at least 65 years of age were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Data File (MBSAQIP PUF). Selected cases were stratified by race. Outcomes were compared between matched racial cohorts. Multivariate regression analyses were performed to determine whether race independently predicted morbidity. RESULTS From 2015 to 2018, 29,394 elderly NHW (90.8%) and NHB (9.2%) patients underwent an RYGB or SG. At baseline, NHB elderly patients had a higher burden of co-morbid conditions, resulting in higher rates of overall (7.7% versus 6.4%, P = .009) and bariatric-related (5.4% versus 4.1%, P = .001) morbidity. All outcome measures were similar between propensity-score-matched racial elderly bariatric patient cohorts. On regression analysis, NHB race remained independently correlated with morbidity (odds ratio [OR] 1.3, 95% CI 1.08-1.47, P = .003). CONCLUSION RYGB and SG are safe in elderly patient cohorts, with no differences in adverse outcomes between NHB and NHW patients, accounting for confounding factors. While race does not appear to impact outcomes in the elderly cohorts, NHB race may play a role in access.
Collapse
Affiliation(s)
| | - Shilpa Agarwal
- Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Michael Mazzei
- Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| |
Collapse
|
27
|
Edwards MA, Mazzei M, Agarwal S, Rhodes L, Bruff A. Exploring perioperative outcomes in metabolic and bariatric surgery amongst the elderly: an analysis of the 2015-2017 MBSAQIP database. Surg Obes Relat Dis 2021; 17:1096-1106. [PMID: 33785272 DOI: 10.1016/j.soard.2021.02.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/24/2020] [Accepted: 02/16/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) is increasingly performed in patients >65 years. Studies of perioperative outcomes have shown equivocal results. OBJECTIVES Our study objective was to explore perioperative outcomes in elderly MBS patients compared with those <65 years. SETTING Academic Hospital. METHODS Primary sleeve (SG) and gastric bypass (RYGB) cases were identified from the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Selected cases were stratified by age (≥65 yr versus <65 yr). Univariate and multivariate logistic regression analyses were performed comparing outcomes in the elderly with the general MBS cohort. RESULTS 26,557 (5.6%) of MBS cases were performed in elderly patients, who were more likely to be white, male, have a lower mean body mass index (BMI), receive a gastric bypass, and robotic-assisted surgery. Elderly patients had a significantly higher disease burden, and most outcome measures were significantly higher in elderly patients, including mortality and morbidity. On multivariate regression analyses, elderly patients undergoing SG have significantly less risk of mortality and morbidity compared with RYGB. In general, co-morbidities were in most cases more strongly predictive of complications than age alone. The number needed to harm (NNH) for overall and related morbidity were 59 and 232, respectively. CONCLUSION Elderly MBS patients have higher disease burden and higher adverse outcomes following MBS; however, complications in this cohort remain overall rare. When performing bariatric surgery on elderly patients, procedure consideration should favor SG as RYGB is independently associated with worse outcomes.
Collapse
Affiliation(s)
| | - Michael Mazzei
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Shilpa Agarwal
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Lori Rhodes
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| | - Allison Bruff
- Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Temple University Hospital, Philadelphia, Pennsylvania
| |
Collapse
|
28
|
Comparison of the incidence of cholelithiasis after sleeve gastrectomy and Roux-en-Y gastric bypass: a meta-analysis. Surg Obes Relat Dis 2021; 17:1198-1205. [PMID: 33785273 DOI: 10.1016/j.soard.2021.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/28/2021] [Accepted: 02/04/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Bariatric surgery could increase the risk of cholelithiasis, although it is unclear whether the incidence rates of cholelithiasis are similar after different bariatric procedures. OBJECTIVES To compare the incidence rates of cholelithiasis after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in people with obesity. SETTING Meta-analysis of cohort studies. METHODS We searched the PubMed and Web of Science databases for relevant studies before December 2020, and estimated the summary odds ratios (OR) and 95% confidence intervals (CI) using a random-effects model or fixed-effects model, according to the heterogeneity. RESULTS In total, 8 cohort studies were included in this meta-analysis, and 94,855 and 106,844 participants received SG and RYGB, respectively. Compared with those receiving RYGB, the summary results showed that participants receiving SG had a 35% lower rate of cholelithiasis (OR, .65; 95% CI, .49-.86). Also, the participants receiving SG had a significantly lower incidence of cholecystectomy than those receiving RYGB (OR, .54; 95% CI, .30-.99). In a subgroup analysis, SG was associated with a significantly lower incidence of subsequent cholelithiasis than RYGB in both Western and non-Western countries. SG led to a significantly lower incidence of cholelithiasis than RYGB only when the follow-up was <2 years instead of over 2 years. CONCLUSION Participants receiving SG had a significantly lower incidence of cholelithiasis than those receiving RYGB, particularly within the first 2 years after the bariatric surgery.
Collapse
|
29
|
Vallois A, Menahem B, Alves A. Is Laparoscopic Bariatric Surgery Safe and Effective in Patients over 60 Years of Age?" an Updated Systematic Review and Meta-Analysis. Obes Surg 2020; 30:5059-5070. [PMID: 33030672 DOI: 10.1007/s11695-020-04994-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 01/11/2023]
Abstract
To evaluate, mid-term outcomes between elderly patients (EP, i.e., age > 60 years old) and young patients (YP, i.e., age < = 60 years old) who underwent laparoscopic bariatric surgery. Studies comparing EP versus YP for bariatric surgery published until April 2020 were selected and submitted to a systematic review and meta-analysis. After LSG, overall morbidity and specific post-operative complication rates (i.e., leak, abscess, hemorrhage, and reoperation) were significantly more frequent in EP compared with those in YP. Surgical outcomes were similar between EP and YP after LRYGB. Both procedures achieved weight loss, but it was statistically greater in YP compared with that in EP. In summary, this meta-analysis suggests that laparoscopic bariatric surgery is a safe and effective treatment in EP compared with that in YP.
Collapse
Affiliation(s)
- Antoine Vallois
- Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033, Caen cedex, France
| | - Benjamin Menahem
- Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033, Caen cedex, France.
- ANTICIPE INSERM U 1086, Avenue du Général Harris, Centre François Baclesse, 14045, Caen cedex, France.
- Pôle de Formation et de recherche en santé, 2 rue des Rochambelles, 14032, Caen cedex, France.
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033, Caen cedex, France
- ANTICIPE INSERM U 1086, Avenue du Général Harris, Centre François Baclesse, 14045, Caen cedex, France
- Pôle de Formation et de recherche en santé, 2 rue des Rochambelles, 14032, Caen cedex, France
| |
Collapse
|