Busetto Luca, Angrisani Luigi, Basso Nicola, Favretti Franco, Furbetta Francesco, Lorenzo Michele
Università degli Studi di Padova, Clinica Medica 1, Padova, Italy.
Obesity (Silver Spring). 2008 Feb;16(2):334-8. doi: 10.1038/oby.2007.85.
Bariatric surgery is not usually recommended in the elderly. The aim of this study is to evaluate the safety and efficacy of laparoscopic adjustable gastric banding (LAGB) in older patients registered in the database of the Italian Group for Lap-Band Gruppo Italiano Lap-Band (GILB).
GILB is a centralized database which collects operative and follow-up data from 26 Italian surgical centers who utilize the Lap-Band System as a restrictive procedure. Patients > or =60 years were selected from the database of the GILB and analyzed according to co-morbidities, conversion, peri-operative complications, and weight loss.
Of 5,290 patients, 216 (4.1%; 184F/32M) were > or =60 years old at surgery (mean age 64.1 +/- 4.0 years; range 60-83). Baseline BMI was similar in both sets of patients i.e., > or =60 and <60 years of age (44.2 +/- 7.6 kg/m(2) vs. 44.9 +/- 7.4 kg/m(2)). Patients > or =60 years of age were more frequently affected by co-morbidities than patients <60 years of age. Two cases of operative mortality were observed in patients <60 years old (0.04%) and one in patients > or =60 years old (0.46%). The proportion of patients requiring revision surgery was comparable as well. Weight loss was significantly lower in elderly patients. Despite their lower weight loss, patients > or =60 years of age experienced a significant improvement of obesity-related co-morbidities (they showed improvement 1 year after surgery in 100% of cases of diabetes or sleep apnoea, 67.1% of cases of hypertension, and 34.9% of cases of osteoarthritis).
LAGB may be performed safely in patients > or =60 years old. Weight loss in older patients seems unsatisfactory if compared to younger subjects. However, the majority of elderly patients show an improvement in obesity-related co-morbidities.
通常不建议对老年人进行减肥手术。本研究旨在评估在意大利腹腔镜胃束带术组（GILB）数据库中登记的老年患者行腹腔镜可调节胃束带术（LAGB）的安全性和有效性。
GILB是一个集中式数据库，收集来自26个使用胃束带系统作为限制性手术的意大利外科中心的手术及随访数据。从GILB数据库中选取年龄≥60岁的患者，并根据合并症、中转情况、围手术期并发症及体重减轻情况进行分析。
在5290例患者中，216例（4.1%；184例女性/32例男性）手术时年龄≥60岁（平均年龄64.1±4.0岁；范围60 - 83岁）。两组患者（即年龄≥60岁和<60岁）的基线体重指数相似（分别为44.2±7.6kg/m²和44.9±7.4kg/m²）。年龄≥60岁的患者比年龄<60岁的患者更常合并其他疾病。在年龄<60岁的患者中观察到2例手术死亡（0.04%），在年龄≥60岁的患者中观察到1例手术死亡（0.46%）。需要翻修手术的患者比例也相当。老年患者的体重减轻明显较低。尽管体重减轻较少，但年龄≥60岁的患者肥胖相关合并症有显著改善（100%的糖尿病或睡眠呼吸暂停病例、67.1%的高血压病例以及34.9%的骨关节炎病例在术后1年显示改善）。
LAGB在年龄≥60岁的患者中可安全进行。与年轻患者相比，老年患者的体重减轻似乎不令人满意。然而，大多数老年患者肥胖相关合并症有改善。
