Wool Daniel, Bellatorre Nina, Wren Sherry, Eisenberg Dan
Department of Surgery, Palo Alto VA HCS and Stanford School of Medicine, 3801 Miranda Avenue, Palo Alto, CA, 94304, USA.
Obes Surg. 2009 Jan;19(1):18-21. doi: 10.1007/s11695-008-9734-1. Epub 2008 Oct 15.
It is estimated that 25% of Americans older than 60 years are obese. Male gender and advanced age are indicators of increased risk for bariatric surgery. Good results have been shown in patients older than 50, but nearly all published studies include a large majority of females, and few include patients >60 years old. In this study, we examined the results of males over 60 years old.
We reviewed a prospective database of 107 consecutive patients who underwent bariatric surgery between April 2002 and June 2007 at the Palo Alto VA. Of these, 60 patients were males older than 50 and available for follow-up 12 months postoperatively. There were 47 males 50-59 years old (group I) and 13 males older than 60 years (group II). Data were analyzed using Student's t test.
Mean preoperative body mass index was similar in both groups (49.4 vs. 47.5 kg/m(2); p = 0.468). Length of hospital stay was similar (3.2 vs. 3.5 days; p = 0.678), but early morbidity was higher in group II patients (30.8% vs. 8.5%; p = 0.037). Morbidity included urinary tract infection, cardiac arrhythmias, and early bowel obstruction. Excess weight loss after 1 year was not significantly different (63.6% vs. 60.6%; p = 0.565). Diabetes resolution or improvement was seen in 87% of group I patients and 90% of group II patients.
Despite a higher early morbidity rate, obese males >/=60 years old perform as well as male patients 50-59 years old with respect to excess weight loss, mortality, length of stay, and improvement of diabetes, at 1 year postoperatively.
据估计,60岁以上的美国人中有25%患有肥胖症。男性和高龄是减肥手术风险增加的指标。50岁以上的患者已显示出良好的效果,但几乎所有已发表的研究都包括绝大多数女性,很少有研究纳入60岁以上的患者。在本研究中,我们检查了60岁以上男性的手术结果。
我们回顾了2002年4月至2007年6月在帕洛阿尔托退伍军人管理局接受减肥手术的107例连续患者的前瞻性数据库。其中,60例患者为50岁以上男性,术后12个月可进行随访。有47例50 - 59岁的男性(第一组)和13例60岁以上的男性(第二组)。数据采用学生t检验进行分析。
两组术前平均体重指数相似(49.4对47.5kg/m²;p = 0.468)。住院时间相似(3.2对3.5天;p = 0.678),但第二组患者的早期并发症发生率较高(30.8%对8.5%;p = 0.037)。并发症包括尿路感染、心律失常和早期肠梗阻。1年后的超重减轻情况无显著差异(63.6%对60.6%;p = 0.565)。第一组87%的患者和第二组90%的患者糖尿病得到缓解或改善。
尽管早期并发症发生率较高,但60岁及以上的肥胖男性在术后1年的超重减轻、死亡率、住院时间和糖尿病改善方面与50 - 59岁的男性患者表现相当。