Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
Department of Surgery, Riviera-Chablais Hospital, Aigle-Monthey, Switzerland.
Obes Surg. 2020 Apr;30(4):1181-1188. doi: 10.1007/s11695-019-04181-z.
Conflicting data have been published for bariatric surgery in older patients, with no long-term large-scale studies available. Our aim was to provide long-term (> 10 years) results on weight loss, metabolic outcomes, and quality of life in a large homogenous series of Roux-en-Y gastric bypass (RYGB) patients, according to age at baseline.
All consecutive patients who underwent primary RYGB between 1999 and 2007, and therefore eligible for 10-year follow-up, were retrospectively analyzed. According to their age at baseline, they were divided into three groups: A (< 40 years), B (40-54 years), and C (≥ 55 years). Categorical variables were compared with the χ test and continuous variables with ANOVA.
Our series consisted of 820 patients, with a 10-year follow-up of 80.6%. Although group C (11% of all patients) had significantly more comorbidities at baseline, there was no difference in postoperative morbidity and mortality between groups. Weight loss was significantly less for group C patients up to the 7th postoperative year, but no difference remained thereafter. 10-year %total weight loss was 32.2, 32.9, and 32.3 respectively in groups A, B, and C. After 10 years, glycemic control and lipid profile improved similarly, rates of partial or complete remission of diabetes and hypertension were identical, and quality of life presented a significant improvement for all patients with no inter-group difference.
Our results suggest similar short- and long-term outcomes after RYGB for patients ≥ 55 years compared to younger ones; the relative benefit might even be higher for older patients, given their increased comorbidity at baseline.
针对老年患者行减重手术的相关数据存在争议，目前尚无长期的大规模研究。我们旨在提供一项大型、同质性的 Roux-en-Y 胃旁路术（RYGB）患者队列的长期（>10 年）随访结果，以评估基线时的年龄对减重效果、代谢结局和生活质量的影响。
回顾性分析了 1999 年至 2007 年间行原发性 RYGB 的所有连续患者，这些患者有资格进行 10 年随访。根据基线时的年龄，将他们分为三组：A 组（<40 岁）、B 组（40-54 岁）和 C 组（≥55 岁）。分类变量采用卡方检验进行比较，连续变量采用方差分析。
我们的系列研究共纳入了 820 例患者，10 年随访率为 80.6%。尽管 C 组（占所有患者的 11%）基线时合并症更多，但各组之间的术后发病率和死亡率无差异。C 组患者在术后第 7 年之前的体重减轻量显著减少，但此后无差异。A、B 和 C 组的 10 年总体重减轻百分比分别为 32.2%、32.9%和 32.3%。10 年后，血糖控制和血脂谱改善情况相似，糖尿病和高血压部分或完全缓解率相同，所有患者的生活质量均显著改善，且各组之间无差异。
与年轻患者相比，≥55 岁的患者行 RYGB 后具有相似的短期和长期效果；鉴于基线时合并症更多，老年患者的相对获益可能更高。
