Trieu Huy T, Gonzalvo John Paul, Szomstein Samuel, Rosenthal Raul
Bariatric Institute and Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida, USA.
Surg Obes Relat Dis. 2007 May-Jun;3(3):383-6. doi: 10.1016/j.soard.2006.12.011. Epub 2007 Apr 2.
Many surgeons are hesitant to offer bariatric surgery to patients >60 years of age because of concern of the considerably greater perioperative risk and less weight-control efficacy. We hypothesized that laparoscopic Roux-en-Y gastric bypass (LRYGB) can be performed in this patient population with acceptable morbidity 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, preoperative and postoperative weight and body mass index (BMI), and postoperative complications.
A total of 92 patients >60 years who had undergone LRYGB were reviewed in this study. The mean preoperative weight and BMI was 136.6 kg and 48.4 kg/m(2), respectively. The mean postoperative weight and BMI was 100.3 kg and 35.9 kg/m(2), respectively. The mean percentage of excess weight loss was 53.85%. The early complications were an anastomotic leak in 2 patients (2.2%), intraluminal hemorrhage in 1 patient (1.1%), pulmonary embolus in 1 patient (1.1%), pneumonia in 1 patient (1.1%), and atrial fibrillation in 1 patient (1.1%). The late complications included stenosis at the gastrojejunostomy in 8 patients (8.6%), marginal ulceration in 3 (3.2%), small bowel obstruction in 1 (1.1%), internal hernia in 1 (1.1%), and abdominal wall hernia in 1. No mortality occurred.
LRYGB can be performed safely and can achieve effective weight control in patients >60 years of age.
许多外科医生对于为60岁以上患者实施减肥手术犹豫不决,因为担心围手术期风险显著更高且体重控制效果较差。我们推测腹腔镜Roux-en-Y胃旁路术(LRYGB)可在该患者群体中实施,且发病率可接受,并能实现有效的体重控制。
对2001年至2004年在佛罗里达州克利夫兰诊所减肥研究所接受LRYGB手术的60岁以上患者进行回顾性研究。评估的数据包括年龄、性别、术前和术后体重及体重指数(BMI)以及术后并发症。
本研究共纳入92例接受LRYGB手术的60岁以上患者。术前平均体重和BMI分别为136.6千克和48.4千克/平方米。术后平均体重和BMI分别为100.3千克和35.9千克/平方米。平均超重减轻百分比为53.85%。早期并发症包括2例(2.2%)吻合口漏、1例(1.1%)腔内出血、1例(1.1%)肺栓塞、1例(1.1%)肺炎和1例(1.1%)心房颤动。晚期并发症包括8例(8.6%)胃空肠吻合口狭窄、3例(3.2%)边缘溃疡、1例(1.1%)小肠梗阻、1例(1.1%)内疝和1例腹壁疝。无死亡病例。
LRYGB可安全实施,并能在60岁以上患者中实现有效的体重控制。