Parmar Chetan, Mahawar Kamal K, Carr William R J, Schroeder Norbert, Balupuri Shlok, Small Peter K
Bariatric Unit, Department of Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
Obes Surg. 2017 Dec;27(12):3165-3169. doi: 10.1007/s11695-017-2739-x.
There is reluctance amongst many healthcare professionals to offer bariatric surgery to septuagenarians. There is only one study in the scientific literature specifically describing any experience with this group of patients and none that compares the outcomes in this group with younger patients.
We retrospectively examined our prospective database to identify all those who were >70 years old at the time of bariatric surgery. This group was then compared with a matched (for sex, body mass index, surgical procedure, and time of surgery) cohort of younger (<60 year old) patients. Information was obtained from our database, case notes, hospital electronic records, by interviewing team members, and from general practitioners.
A total of 10 septuagenarians were compared with 10 younger patients (mean age 41 years). There were one early complication and 1 late complication in the over 70 group as opposed to no early complication and 2 late complications in the younger group. There was no mortality or early reoperation in either group. Excess weight loss of 50.4, 67.4, and 74.0% in the >70 age group at 6, 12, and 24 months, respectively, was no different to 51.3, 70.8, and 73.9% in <60 year olds. The effect on the co-morbidity resolution was similar in the two groups.
In carefully selected septuagenarians, bariatric surgery can be performed with safety and efficacy comparable to those <60 years old.
许多医疗保健专业人员不愿为七十多岁的老人提供减肥手术。科学文献中仅有一项研究专门描述了对这组患者的任何经验，没有一项研究将该组患者的结果与年轻患者进行比较。
我们回顾性检查了前瞻性数据库，以确定所有在减肥手术时年龄大于70岁的患者。然后将该组患者与年龄匹配（性别、体重指数、手术方式和手术时间）的年轻（<60岁）患者队列进行比较。信息从我们的数据库、病历、医院电子记录中获取，通过采访团队成员以及从全科医生处获得。
共将10名七十多岁的老人与10名年轻患者（平均年龄41岁）进行了比较。70岁以上组有1例早期并发症和1例晚期并发症，而年轻组无早期并发症，有2例晚期并发症。两组均无死亡或早期再次手术情况。70岁以上年龄组在6个月、12个月和24个月时的超重减轻分别为50.4%、67.4%和74.0%，与60岁以下组的51.3%、70.8%和73.9%无差异。两组对合并症缓解的效果相似。
在经过精心挑选的七十多岁老人中，减肥手术的安全性和有效性与60岁以下的患者相当。
