John Flynn Hospital, Tugun, QLD, Australia.
Obes Surg. 2011 Jan;21(1):10-7. doi: 10.1007/s11695-010-0158-3.
The aggressive pursuit of weight loss in the elderly remains a controversial objective. In this series of 113 patients over 60 years of age who underwent laparoscopic gastric banding surgery, we report on complications, co-morbidity change, quality-of-life improvement and changes in medication use over a median follow-up period of 25.5 months.
A prospectively kept database was reviewed from January 1999 to September 2008 identifying patients over 60 who underwent gastric banding surgery. Baseline and follow-up SF-36® survey scores were compared longitudinally. Co-morbidity change and medication use were assessed by questionnaire and electronic record review.
Major complications were experienced by 7.1% over the follow-up period with a re-operation rate of 15.0%. Excess BMI loss was 44.1% after 5 years and combined mean SF-36® quality-of-life scores (out of 100) improved 22.1 points, achieving parity with age-matched norms for the general population. Diabetes improved in 74.2% with hypertension, hyperlipidaemia and depression improving in 57.1, 51.1 and 35.9% of cases. A significant drop in medication use was not seen, and cancer was responsible for three deaths over the follow-up period. No surgical mortality was incurred.
Laparoscopic gastric banding can markedly improve quality of life for morbidly obese over 60s. Health gains are significant, but medication use is not substantially altered. Gastric banding is an ideal weight loss operation for this age group due to its safety and efficacy, and the primary goal should be quality-of-life improvement.
老年人积极追求减肥仍然是一个有争议的目标。在这一系列 113 名 60 岁以上接受腹腔镜胃带手术的患者中，我们报告了并发症、合并症变化、生活质量改善以及中位数随访期 25.5 个月内药物使用变化的情况。
从 1999 年 1 月至 2008 年 9 月，我们通过前瞻性保存的数据库，确定了接受胃带手术的 60 岁以上患者。比较了基线和随访期间的 SF-36®调查评分。通过问卷调查和电子记录回顾评估合并症变化和药物使用情况。
在随访期间，7.1%的患者发生了重大并发症，再手术率为 15.0%。5 年后，多余的 BMI 减轻了 44.1%，综合平均 SF-36®生活质量评分（满分 100 分）提高了 22.1 分，达到了与同龄人群相匹配的一般人群的水平。74.2%的糖尿病患者病情改善，57.1%、51.1%和 35.9%的高血压、高血脂和抑郁症患者病情改善。药物使用量并没有显著下降，在随访期间有 3 例癌症死亡。没有发生手术相关死亡。
腹腔镜胃带术可以显著改善 60 岁以上病态肥胖患者的生活质量。健康收益显著，但药物使用并未大幅改变。胃带术是该年龄段患者理想的减肥手术，因为它安全有效，主要目标应该是提高生活质量。
