Department of General Surgery B, Emek Medical Center, Afula, Israel.
Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Obes Surg. 2018 Aug;28(8):2165-2170. doi: 10.1007/s11695-018-3160-9.
Older age (> 60) has been considered a relative contraindication for bariatric surgery due to increased complication risk. This study examined the risks and benefits of bariatric surgery for patients older than 60 years in Canadian population.
This was a retrospective cohort study of the Ontario Bariatric Registry: a database recording peri-operative and post-operative outcomes of publicly funded bariatric surgeries across the province. Patients who completed 1 year follow-up, who underwent laparoscopic gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between January 2010 and May 2013, were divided into older (> 60) and younger (> 60) cohorts, and outcomes were compared.
Between January 2010 and May 2013, 3166 registry patients underwent LRYGB or LSG and completed 1-year follow-up. Of these, 204 (6.5%) were older than 60 years, with 175 (85.8%) undergoing LRYGB and 29 (14.2%) LSG. Demographics were similar, except for a higher number of males in the older group (59 (28.9%) versus 452 (15.3%) (p < 0.001)). No significant difference in complication rate was noted (15% for younger cohort versus 13.8% (p = 0.889)). The average percentage of excess weight loss was significantly higher in the younger population (60.72% versus 56.25% (p < 0.05)) overall, however not significantly in the LSG group. Reduction in medication use post-surgery for management of co-morbidities was significantly higher in the older patients (- 0.91 versus - 2.03 (p < 0.001)).
The older cohort who underwent LRYGB or LSG was at no greater risk for intra-operative and post-operative complications and showed greater reduction in medication use post-surgery when compared to the younger cohort.
由于并发症风险增加，年龄较大（>60 岁）被认为是减重手术的相对禁忌症。本研究检查了加拿大人群中年龄>60 岁的患者接受减重手术的风险和益处。
这是一项对安大略省减重登记处的回顾性队列研究：该数据库记录了全省公共资助减重手术的围手术期和术后结果。完成 1 年随访、2010 年 1 月至 2013 年 5 月期间接受腹腔镜胃旁路术（LRYGB）或腹腔镜袖状胃切除术（LSG）的患者被分为年龄较大（>60 岁）和年龄较小（>60 岁）两组，并比较了结果。
2010 年 1 月至 2013 年 5 月期间，3166 名登记患者接受了 LRYGB 或 LSG 手术并完成了 1 年随访。其中，204 名（6.5%）年龄>60 岁，其中 175 名（85.8%）接受了 LRYGB 手术，29 名（14.2%）接受了 LSG 手术。除了年龄较大的组中男性人数较多（59 名（28.9%）比 452 名（15.3%）（p<0.001））外，两组患者的人口统计学特征相似。并发症发生率无显著差异（年轻组为 15%，老年组为 13.8%（p=0.889））。总体而言，年轻人群的超重减轻百分比明显更高（60.72%比 56.25%（p<0.05）），但 LSG 组则不明显。与年轻组相比，老年患者术后用于治疗合并症的药物使用减少更为显著（-0.91 比-2.03（p<0.001））。
与年轻组相比，接受 LRYGB 或 LSG 的老年组在手术中和手术后并发症方面的风险没有增加，并且术后药物使用减少更为显著。
