Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, France.
Université Côte d'Azur, Nice, France.
Obes Surg. 2023 Dec;33(12):3850-3859. doi: 10.1007/s11695-023-06851-5. Epub 2023 Oct 16.
An increasing Pnumber of individuals with obesity over the age of 60 years require bariatric surgery to treat obesity and its related medical problems. Sleeve gastrectomy and Roux-en-Y gastric bypass have already proven their efficacy in this population, but literature lacks reports of long-term results. The aim of this study is to compare long-term results of sleeve gastrectomy and Roux-en-Y gastric bypass in individuals older than 60 years old.
This is a single-center, retrospective, comparative study of 204 patients undergoing either sleeve gastrectomy (123, 60.3%) or Roux-en-Y gastric bypass (81, 39.7%) for morbid obesity with a mean follow-up of 44.5 ± 19.1 months and 54.6 ± 17.9 months, respectively.
Total weight loss was significantly increased for patients who underwent Roux-en-Y gastric bypass compared to sleeve gastrectomy from 12 to 48 months after surgery, while no significant difference was found after 60 (30.39% vs. 27.63%) and 72 (27.36% vs. 23.61%) months. Roux-en-Y gastric bypass was associated to a significant increased rate of early postoperative complications (22.2% vs. 4%; p < 0.0001), but no difference was found concerning late postoperative morbidity (6.2% vs. 1.6%). Both procedures were effective in obesity related medical problems.
Roux-en-Y gastric bypass confers an increased weight loss than sleeve gastrectomy in patients over the age of 60 in the mid-term, but it is associated with more early postoperative complications. Sleeve gastrectomy can be considered a valid alternative as long-term weight loss results are superposable to those ensured by Roux-en-Y gastric bypass.
越来越多 60 岁以上肥胖患者需要接受减重手术来治疗肥胖及其相关的医学问题。袖状胃切除术和 Roux-en-Y 胃旁路术已经在该人群中证明了其疗效,但文献缺乏长期结果的报告。本研究旨在比较 60 岁以上患者行袖状胃切除术和 Roux-en-Y 胃旁路术的长期结果。
这是一项单中心回顾性比较研究,纳入 204 例因病态肥胖行袖状胃切除术(123 例,60.3%)或 Roux-en-Y 胃旁路术(81 例,39.7%)的患者,平均随访 44.5±19.1 个月和 54.6±17.9 个月。
Roux-en-Y 胃旁路术组患者的总体重减轻率从术后 12 个月到 48 个月明显高于袖状胃切除术组,而术后 60 个月和 72 个月时两组间无显著差异(30.39%比 27.63%和 27.36%比 23.61%)。Roux-en-Y 胃旁路术与术后早期并发症发生率显著增加相关(22.2%比 4%;p<0.0001),但术后晚期发病率无差异(6.2%比 1.6%)。两种手术均对肥胖相关的医学问题有效。
在中期,Roux-en-Y 胃旁路术比袖状胃切除术在 60 岁以上患者中提供了更多的体重减轻,但它与更多的术后早期并发症相关。只要长期的减重效果与 Roux-en-Y 胃旁路术相当,袖状胃切除术就可以被认为是一种有效的替代方案。