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55岁及以上肥胖症患者的腹腔镜Roux-en-Y胃旁路手术

Laparoscopic Roux-en-Y gastric bypass in morbidly obese patients > or =55 years old.

作者信息

Fazylov Rafael, Soto Eliana, Merola Stephen

机构信息

Department of Surgery, New York Hospital Queens, New York, NY, USA.

出版信息

Obes Surg. 2008 Jun;18(6):656-9. doi: 10.1007/s11695-007-9364-z. Epub 2008 Apr 12.

Abstract

BACKGROUND

Advanced age is considered a relative contraindication to bariatric surgery at some institutions because of concerns about higher morbidity and less than optimal weight loss. The aim of our study was to evaluate the operative outcomes, length of stay, weight loss, and improvement of comorbidities in patients > or =55 years old who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery in our institution.

METHODS

Retrospective data on 33 patients (26 women and 7 men) > or =55 years of age who underwent LRYGB from January 2003 to December 2006 were reviewed.

RESULTS

Average patient age was 59 years (range 55-68 years), and the mean preoperative body mass index was 47 kg/m2 (range 41.1-55.8 kg/m2). The median length of hospital stay was 3 days. There were no intraoperative or postoperative deaths. Early complications were one anastomotic leak, two upper gastrointestinal bleedings, and two readmissions for intractable vomiting. Late complications included four anastomotic strictures and one small bowel obstruction. Patients were followed for a mean 13 months (range 3-24 months). The mean excess body weight (EBW) loss was 13.5 kg (23%), 23.3 kg (39.8%), 33.3 kg (58.1%), 39.8 kg (66.8%), 40.1 kg (69.5%), and 40.8 kg (75.3%) at 1, 3, 6, 9, 12 and 24 months, respectively. Diabetes mellitus improved in 19 (100%) patients and completely resolved in 10 (53%). Hypertension improved in 18 (64%) patients, completely resolved in 9 (32%) and was unchanged in 10 (36%).

CONCLUSIONS

LRYGB is safe and effective in morbidly obese patients > or =55 years of age.

摘要

背景

在一些机构中,由于担心较高的发病率以及体重减轻效果不理想,高龄被视为减重手术的相对禁忌证。我们研究的目的是评估在我院接受腹腔镜Roux-en-Y胃旁路术(LRYGB)的年龄≥55岁患者的手术结果、住院时间、体重减轻情况以及合并症的改善情况。

方法

回顾性分析2003年1月至2006年12月期间33例年龄≥55岁(26例女性和7例男性)接受LRYGB手术患者的资料。

结果

患者平均年龄为59岁(范围55 - 68岁),术前平均体重指数为47 kg/m²(范围41.1 - 55.8 kg/m²)。中位住院时间为3天。无术中或术后死亡病例。早期并发症包括1例吻合口漏、2例上消化道出血以及2例因顽固性呕吐再次入院。晚期并发症包括4例吻合口狭窄和1例小肠梗阻。患者平均随访13个月(范围3 - 24个月)。1、3、6、9、12和24个月时平均多余体重(EBW)减轻分别为13.5 kg(23%)、23.3 kg(39.8%)、33.3 kg(58.1%)、39.8 kg(66.8%)、40.1 kg(69.5%)和40.8 kg(75.3%)。19例(100%)糖尿病患者病情改善,10例(53%)完全缓解。18例(64%)高血压患者病情改善,9例(32%)完全缓解,10例(36%)无变化。

结论

LRYGB对于年龄≥55岁的病态肥胖患者是安全有效的。

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