Midterm outcomes of gastric bypass for elderly (aged ≥ 60 yr) patients: a comparative study.

BACKGROUND

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is feasible for patients aged 60 years and older and is associated with a favorable early weight loss. However, data with longer follow-up in this age group are scarce. The present study compared weight loss and changes in co-morbidities 3 years after LRYGB between older patients (OP; ≥ 60 yr) and younger patients (YP; <60 yr). Data were collected prospectively in a single surgery university center (Paris, France).

METHODS

Between January 2004 and May 2011, 48 OP and 610 YP underwent LRYGB. Three-year outcomes were available for 42 (87.5%) OP and 480 (78.7%) YP; 42 OP undergoing LRYGB were matched with 84 YP for sex, preoperative body mass index (BMI), and presence of type 2 diabetes.

RESULTS

The sample was 81% female; preoperative BMI was 45.6 ± 6.4 kg/m² in OP versus 47.3 ± 5.2 kg/m² in YP patients (P = .12), and age was 62.6 ± 2.3 years in OP versus 42.9 ± 8.7 years in YP (P < .0001). The prevalence of coexisting conditions was comparable in both groups except for dyslipidemia (66.7% in OP versus 42.9% in YP; P = .01). At 3 years, percentage of weight loss and BMI change (kg/m²) was significantly lower in the OP group compared with YP (27.5 ± 8.6 versus 31.8 ± 12.1, P = .04; and -12.7 ± 4.9 versus -15.2 ± 6.2, P = .03). The rate of remission of hypertension was lower in OP than in YP (18.8% versus 53.8%; P = .002), as was that of both obstructive sleep apnea (60.6% versus 87.9%; P = .004) and dyslipidemia (42.9% versus 75.0%; P = .01).

CONCLUSIONS

At 3 years, despite less favorable impact on weight than for younger patients, LRYGB provided significant weight loss and remission of co-morbidities for patients aged > 60 years. Long-term trials are needed to better evaluate the benefit of bariatric surgery in aging obese patients.