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60岁以上患者行袖状胃切除术的结局:一项多中心配对病例对照研究。

Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study.

作者信息

Dowgiałło-Wnukiewicz Natalia, Janik Michal R, Lech Pawel, Major Piotr, Pędziwiatr Michał, Kowalewski Piotr K, Walędziak Maciej, Wysocki Michał, Michalik Maciej

机构信息

Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn, Poland.

Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2020 Mar;15(1):123-128. doi: 10.5114/wiitm.2019.81450. Epub 2019 Jan 22.

Abstract

INTRODUCTION

The prevalence of obesity is increasing according to the World Health Organization. Furthermore, global aging is increasing, especially in developed countries in Europe. Whether bariatric surgery should be performed in elderly people is still controversial.

AIM

To determine the clinical outcomes of sleeve gastrectomies (SG) in older central European patients. We compared the safety and efficacy of SG in patients older than 60 years with younger patients.

MATERIAL AND METHODS

Eighty-nine patients older than 60 years, who underwent SG, were included in the study. Eighty-nine younger patients (aged 18-40 years) were matched according to body mass index (BMI) and comorbidities. The analyzed data included age, sex, total body weight, BMI, length of hospital stay, 30-day complications and improvement in comorbidities.

RESULTS

There was no significant difference in the complication rate between the 2 age groups (p = 0.59). An improvement in hypertension was observed in 73.1% of older patients and in 69.2% of younger patients (p = 0.67). There was improvement in diabetes mellitus in 40% of older patients and in 31.1% of younger patients (p = 0.25). The ΔBMI after 12, 24 and 36 months was significantly lower in older patients than in younger patients (p = 0.002, p = 0.001; p = 0.043, respectively). Percent excess BMI loss (%EBMIL) after 12, 24, and 60 months was significantly lower in older than in younger patients (p = 0.001, p = 0.001, p = 0.028, respectively).

CONCLUSIONS

Better weight loss is achieved in younger than in older patients, while maintaining a similar effect on the risk of complications and improvement in comorbidities. Therefore, SG is safe and effective in older people.

摘要

引言

世界卫生组织指出,肥胖症的患病率正在上升。此外,全球老龄化也在加剧,尤其是在欧洲的发达国家。老年患者是否应接受减肥手术仍存在争议。

目的

确定中欧老年患者行袖状胃切除术(SG)的临床结果。我们比较了60岁以上患者与年轻患者行SG的安全性和有效性。

材料与方法

本研究纳入了89例行SG的60岁以上患者。根据体重指数(BMI)和合并症匹配了89例年轻患者(年龄18 - 40岁)。分析的数据包括年龄、性别、总体重、BMI、住院时间、30天并发症以及合并症的改善情况。

结果

两个年龄组之间的并发症发生率无显著差异(p = 0.59)。73.1%的老年患者和69.2%的年轻患者高血压得到改善(p = 0.67)。40%的老年患者和31.1%的年轻患者糖尿病得到改善(p = 0.25)。12个月、24个月和36个月后的BMI变化值,老年患者显著低于年轻患者(分别为p = 0.002、p = 0.001;p = 0.043)。12个月、24个月和60个月后的超重BMI损失百分比(%EBMIL),老年患者显著低于年轻患者(分别为p = 0.001、p = 0.001、p = 0.028)。

结论

年轻患者比老年患者减重效果更好,同时在并发症风险和合并症改善方面保持相似效果。因此,SG对老年患者是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b4/7020714/95b22329f561/WIITM-15-34722-g001.jpg

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