Susmallian Sergio, Raziel Asnat, Barnea Royi, Paran Haim
Department of Surgery.
Assia Medical Group.
Medicine (Baltimore). 2019 Jan;98(3):e13824. doi: 10.1097/MD.0000000000013824.
Obesity has become one of the most significant health problems worldwide, affecting more than one-third of the global population. The elderly population is not immune to this proportional increase in obesity. To date, there is no cure for obesity, but surgery is the most effective treatment available today.We analyzed the results of bariatric surgery in elderly patients for a period of 3 years. Patients 65 years old and older were included in the study, 451 older adults were included. The mean age of the study group was 67.92 years old (min. 65, max. 84). The mean body mass index (BMI) was 40.32 Kg/m (min. 34 and max. 59). Sleeve gastrectomy (SG) was the most common procedures, and were conducted in 346 (76.72%) patients, gastric bypasses (GBPs) in 53 (11.75%) of which 33 were roux en y GBP (7.32%) and 20 mini GBPs (4.43%), gastric banding in 48 (10.64%), and duodenal switching in 4 (0.89%) cases.There were 40 (8.86%) patients with perioperative complications, 6 (1.33%) required re-operations, 12 (2.66) patients with operative complications were treated conservatively, 8 (1.77%) re-admission 5 of them with intrabdominal abscess, and 14 (3.10%) with co-morbidities complications. More than 76% of the patients had co-morbidities, 1 year after surgery the average remission of diseases was 34.74%, the improvement was49.67% and no changes in the co-morbidities was 15.59%. There were no deaths reported in this cohort.The mean excess body weight (EBW) loss among the patients was 70.76% (from 32% to 92%). No failure of weight loss (less than 25% of EBW loss) was observed after the first postoperative year.Bariatric surgery offers obese elderly patients an acceptable result, and it can be offered to improve the quality of life of these patients. A new consensus conference panel is needed to set appropriate recommendations regarding criteria that limit bariatric surgery in older adults.
肥胖已成为全球最严重的健康问题之一，影响着超过三分之一的全球人口。老年人群也未能免于肥胖比例的增加。迄今为止，肥胖尚无治愈方法，但手术是目前最有效的治疗手段。我们分析了老年患者3年的减肥手术结果。研究纳入了65岁及以上的患者，共451名老年人。研究组的平均年龄为67.92岁（最小65岁，最大84岁）。平均体重指数（BMI）为40.32 Kg/m（最小34，最大59）。袖状胃切除术（SG）是最常见的手术方式，346例（76.72%）患者接受了该手术，53例（11.75%）接受了胃旁路手术（GBP），其中33例为roux en y GBP（7.32%），20例为迷你GBP（4.43%），48例（10.64%）接受了胃束带术，4例（0.89%）接受了十二指肠转位术。有40例（8.86%）患者出现围手术期并发症，6例（1.33%）需要再次手术，12例（2.66%）手术并发症患者接受了保守治疗，8例（1.77%）再次入院，其中5例患有腹腔内脓肿，14例（3.10%）患有合并症并发症。超过76%的患者患有合并症，术后1年疾病的平均缓解率为34.74%，改善率为49.67%，合并症无变化的比例为15.59%。该队列中无死亡报告。患者的平均超重体重（EBW）减轻了70.76%（从32%到92%）。术后第一年未观察到减肥失败（EBW减轻少于25%）。减肥手术为肥胖老年患者提供了可接受的结果，并且可以用来改善这些患者的生活质量。需要一个新的共识会议小组来制定关于限制老年人减肥手术标准的适当建议。
