General Surgery, Mayo Clinic, Jacksonville, FL, USA.
Department of Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
Obes Surg. 2019 Mar;29(3):1007-1011. doi: 10.1007/s11695-018-03633-2.
Indications and outcomes of bariatric surgery in the elderly remain controversial. We aimed to evaluate and compare safety and early outcomes of bariatric procedures in this age group.
We performed a retrospective case-control study of Mayo Clinic bariatric surgery patients from January 1, 2016, to January 31, 2018. Data collection included surgery type, sex, age, body mass index (BMI), and comorbidities (hypertension, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea (OSA)). Patients aged 65 years old or older were matched with controls younger than 65 years by body mass index (BMI). We assessed length of stay (LOS), perioperative and early postoperative outcomes, short-term weight loss, and complications.
We included 150 bariatric patients, with a case-to-control ratio of 1:2. After laparoscopic sleeve gastrectomy, no significant difference was found in LOS between groups (2.4 vs 2.6 days; P = 0.52), 1-month BMI difference (3.35 vs 3.88; P = 0.17), mean nadir excess BMI loss (%EBL) (22.14 vs 23.2; P = 0.75), or complication rate (0% vs 3.3%; P > 0.99). Similarly, the laparoscopic or robotic-assisted Roux-en-Y gastric bypass (RYGB) cohort showed no difference in LOS (2.65 vs 2.54 days; P = 0.68), 1-month BMI difference (4.72 vs 4.53; P = 0.68), %EBL (31.7 vs 26.6; P = 0.13), or complication rate (11.7% vs 5.71%; P = 0.43).
Although the sample size is small to draw definitive conclusions, bariatric surgery in patients 65 years or older seems to be safe, with similar outcomes and complication rates as in younger patients, regardless of procedure performed.
肥胖症手术在老年人中的适应证和结果仍存在争议。我们旨在评估和比较该年龄组接受此类手术的安全性和早期结果。
我们对 2016 年 1 月 1 日至 2018 年 1 月 31 日期间在梅奥诊所接受减重手术的患者进行了回顾性病例对照研究。数据收集包括手术类型、性别、年龄、体重指数（BMI）和合并症（高血压、糖尿病、高脂血症和阻塞性睡眠呼吸暂停（OSA））。年龄在 65 岁或以上的患者与 BMI 匹配的 65 岁以下对照组患者进行匹配。我们评估了住院时间（LOS）、围手术期和术后早期结果、短期减重和并发症。
我们纳入了 150 例接受减重手术的患者，病例对照比例为 1:2。接受腹腔镜袖状胃切除术（LSG）后，两组间 LOS 无显著差异（2.4 天与 2.6 天；P=0.52），1 个月时 BMI 差值（3.35 千克/平方米与 3.88 千克/平方米；P=0.17），平均体重减轻百分比（%EBL）（22.14%与 23.2%；P=0.75）或并发症发生率（0%与 3.3%；P＞0.99）。同样，腹腔镜或机器人辅助 Roux-en-Y 胃旁路术（RYGB）组在 LOS（2.65 天与 2.54 天；P=0.68）、1 个月时 BMI 差值（4.72 千克/平方米与 4.53 千克/平方米；P=0.68）、%EBL（31.7%与 26.6%；P=0.13）或并发症发生率（11.7%与 5.71%；P=0.43）方面均无差异。
尽管样本量小，无法得出明确的结论，但 65 岁或以上患者接受减重手术是安全的，与年轻患者相比，无论手术方式如何，其结果和并发症发生率相似。
