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70 岁以上患者的减重手术结果。

Outcomes of bariatric surgery in patients >70 years old.

机构信息

Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.

出版信息

Surg Obes Relat Dis. 2012 Jul-Aug;8(4):458-62. doi: 10.1016/j.soard.2012.04.001. Epub 2012 Apr 14.

Abstract

BACKGROUND

The aim of the present study was to report the outcomes of bariatric surgery in patients >70 years of age at a community hospital in the United States.

METHODS

A retrospective review was performed of prospectively collected data from patients aged >70 years who had undergone bariatric surgery at a single institution from 2002 to 2008. The data analyzed included age, preoperative and postoperative weight and body mass index, postoperative complications, and co-morbidities.

RESULTS

Of 42 patients aged >70 years who underwent bariatric surgery, 22 patients (52.4%) had undergone laparoscopic gastric banding, 12 patients (28.6%) laparoscopic sleeve gastrectomy, and 8 patients (19%) laparoscopic Roux-en-Y gastric bypass. The mean preoperative weight and body mass index was 127.4 ± 25.5 kg and 46.8 ± 9.3 kg/m(2), respectively. The mean postoperative weight and body mass index was 100.2 ± 17 kg and 35.5 ± 5.4 kg/m(2), respectively. The median length of follow-up was 12 months (range 1-66). The mean percentage of excess weight loss was 47.7% at 12 months, with 73.1% follow-up data. Complications included wound infections in 4 patients (9.5%), band removal in 3 patients (7.1%), anastomotic leak in 1 patient (2.3%), and megaesophagus in 1 patient (2.3%). No mortality occurred. The postoperative use of medications for hypertension, hyperlipidemia, diabetes mellitus, and degenerative joint disease were reduced by 56%, 54%, 53%, 66%, and 50%, respectively.

CONCLUSION

Bariatric surgery in carefully screened patients aged >70 years can be performed safely and can achieve modest improvement in co-morbidities.

摘要

背景

本研究旨在报告美国社区医院 70 岁以上患者接受减重手术的结果。

方法

对 2002 年至 2008 年期间在一家机构接受减重手术的 70 岁以上患者前瞻性收集的数据进行回顾性分析。分析的数据包括年龄、术前和术后体重和体重指数、术后并发症和合并症。

结果

在 42 名 70 岁以上接受减重手术的患者中,22 名(52.4%)接受了腹腔镜胃带术,12 名(28.6%)接受了腹腔镜袖状胃切除术,8 名(19%)接受了腹腔镜 Roux-en-Y 胃旁路术。术前平均体重和体重指数分别为 127.4 ± 25.5kg 和 46.8 ± 9.3kg/m2。术后平均体重和体重指数分别为 100.2 ± 17kg 和 35.5 ± 5.4kg/m2。中位随访时间为 12 个月(范围 1-66)。术后 12 个月时,超重体重减轻的平均百分比为 47.7%,随访数据为 73.1%。并发症包括 4 例(9.5%)患者的伤口感染、3 例(7.1%)患者的带移除、1 例(2.3%)患者的吻合口漏、1 例(2.3%)患者的巨食管。无死亡发生。术后高血压、高血脂、糖尿病和退行性关节病的药物使用率分别降低了 56%、54%、53%、66%和 50%。

结论

在经过仔细筛选的 70 岁以上患者中进行减重手术是安全的,可以适度改善合并症。

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