Department of Surgery, Grand Rapids Medical Education and Research Center, 221 Michigan Avenue, Suite 200A, Grand Rapids, MI 49503, USA.
Obes Surg. 2010 Sep;20(9):1199-205. doi: 10.1007/s11695-010-0201-4.
Although morbid obesity rates in patients >or=65 years of age are increasing, few centers have reported weight loss surgery outcomes in elderly patients, resulting in a paucity of literature on perioperative mortality and morbidity.
A retrospective analysis was performed on 197 consecutive patients >or=65 years old who underwent weight loss surgery from January 2000 to December 2007. Primary data points included 30-day and 1-year mortality rates, length of stay (LOS), percent excess weight loss (EWL), change in daily medication use, and quality of life (QOL).
The average patient's age was 67.3 years with 72.1% being female. Average preoperative weight and BMI were 131.9 kg and 48.1 kg/m(2), respectively. Average preoperative daily medication use was 8.04 +/- 3.67. Procedure types included Roux-en-Y gastric bypass (79.3%), adjustable gastric banding (17.2%), and vertical sleeve gastrectomy (3%). Ninety-seven percent of procedures were performed laparoscopically. Average LOS was 2.0 +/- 2.1 days. Average weight, BMI, and daily medication use were significantly reduced at 6 months and 1 year (p < 0.001), with patients achieving an average EWL of 44.5% and 55.3% at 6 months and 1 year, respectively. QOL scores improved at 6 months (p < 0.001) and 1 year (p = 0.049). In all patients, the 30-day mortality rate was 0%. The 1-year mortality rate for RYGB patients was 1.3%. Complication rates were acceptable, with 7% of RYGB patients experiencing a major postoperative complication.
Weight loss surgery is effective in patients >or=65 years of age, producing significant EWL, reduction in daily medication use, and improvement in QOL. Surgery is also associated with a low mortality rate and an acceptable morbidity profile.
尽管 65 岁及以上患者的病态肥胖率正在上升,但很少有中心报告老年患者的减肥手术结果,导致围手术期死亡率和发病率的文献很少。
对 2000 年 1 月至 2007 年 12 月期间进行减肥手术的 197 例年龄≥65 岁的连续患者进行回顾性分析。主要数据点包括 30 天和 1 年死亡率、住院时间( LOS )、超重减轻百分比( EWL )、每日用药使用变化和生活质量( QOL )。
患者平均年龄为 67.3 岁,72.1%为女性。术前平均体重和 BMI 分别为 131.9kg 和 48.1kg/m²。术前平均每日用药量为 8.04 ± 3.67。手术类型包括 Roux-en-Y 胃旁路术(79.3%)、可调胃束带术(17.2%)和垂直袖状胃切除术(3%)。97%的手术是腹腔镜下进行的。平均 LOS 为 2.0 ± 2.1 天。平均体重、BMI 和每日用药量在 6 个月和 1 年时显著降低(p < 0.001),患者分别在 6 个月和 1 年时达到平均 EWL 44.5%和 55.3%。QOL 评分在 6 个月(p < 0.001)和 1 年(p = 0.049)时也有所提高。所有患者的 30 天死亡率为 0%。RYGB 患者的 1 年死亡率为 1.3%。并发症发生率可接受,7%的 RYGB 患者发生重大术后并发症。
减肥手术对 65 岁及以上患者有效,可显著减轻体重、减少每日用药量并改善生活质量。手术还与低死亡率和可接受的发病率相关。