Montastier Emilie, Becouarn Guillaume, Bérard Emilie, Guyonnet Sophie, Topart Philippe, Ritz Patrick
UMR1048 INSERM, Obesity Research Laboratory, Institute of Metabolic and Cardiovascular Diseases (I2MC), University of Toulouse III, Toulouse, France.
Department of Nutrition, Toulouse University Hospital, Toulouse, France.
Obes Surg. 2016 Aug;26(8):1806-13. doi: 10.1007/s11695-015-2024-9.
Roux-en-Y gastric bypass (RYGB) has recently been authorized for use in older patients. The objective of this single-center study was to evaluate 2-year weight loss in patients ≥60 years compared with younger matched patients undergoing RYGB. Secondary aims were to record complications and the resolution of comorbidities in a 2-year follow-up.
Of 722 patients with at least 2 years follow-up data, 48 elderly patients were matched with 92 young (<40 years) and 96 middle-aged (40-59 year) patients, according to sex, baseline body mass index, and date of surgery. Weight loss, remission of comorbidities, death, and early (30-day) and 2-year complication rates were compared.
There were three deaths in the elderly group and none in the other groups. The early complication rate was not significantly different in the elderly group (17.8 %) compared with the young (11.5 %, p = 0.637) and middle-aged (13.7 %, p = 1.000) groups. The 2-year complication rates were not significantly different in the elderly group (9.3 %) compared with the young (23.5 %, p = 0.107) and middle-aged (13.2 %, p = 1.000) groups. The 2-year weight loss was lower in the elderly group (31.8 ± 7.2 %; p < 0.001) than in the young group (38.3 ± 6.9 %) but was not significantly different from that in the middle-aged group (34.4 ± 8.0 %; p = 0.145). Remission rates for diabetes and obstructive sleep apnea were lower in the elderly than in the two younger groups.
After bariatric surgery, major weight loss was observed in patients older than 60, but remission of metabolic comorbidities was less marked than in younger subjects.
Roux-en-Y胃旁路术（RYGB）最近已被批准用于老年患者。这项单中心研究的目的是评估60岁及以上患者与接受RYGB的年龄匹配的年轻患者相比，两年内的体重减轻情况。次要目标是记录两年随访中的并发症及合并症的缓解情况。
在722例至少有两年随访数据的患者中，根据性别、基线体重指数和手术日期，将48例老年患者与92例年轻患者（<40岁）和96例中年患者（40-59岁）进行匹配。比较体重减轻、合并症缓解情况、死亡情况以及早期（30天）和两年并发症发生率。
老年组有3例死亡，其他组无死亡。老年组的早期并发症发生率（17.8%）与年轻组（11.5%，p = 0.637）和中年组（13.7%，p = 1.000）相比无显著差异。老年组的两年并发症发生率（9.3%）与年轻组（23.5%，p = 0.107）和中年组（13.2%，p = 1.000）相比无显著差异。老年组的两年体重减轻（31.8±7.2%；p < 0.001）低于年轻组（38.3±6.9%），但与中年组（34.4±8.0%；p = 0.145）无显著差异。老年组糖尿病和阻塞性睡眠呼吸暂停的缓解率低于两个较年轻组。
减肥手术后，60岁以上患者体重显著减轻，但代谢合并症的缓解不如年轻患者明显。
