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THE USE OF SLEEVE GASTRECTOMY FOR ELDERLY AND FRAIL OBESE PATIENTS IS SAFE, AND IT RESOLVES THEIR COMORBIDITIES IN MOST CASES
Date
May 20, 2024
Introduction: In 2000, 600 million persons were aged 60 years or older, simultaneously, the obese population is expanding, and the utilization of bariatric surgery for this population may possess somewhat different short- and long-term operative outcomes compared to a younger population.
Material and Methods: Data on patients who underwent Laparoscopic Sleeve Gastrectomy (LSG) in our university-affiliated Medical Center were included in a prospectively maintained database under IRB approval. A dedicated bariatric surgeon’s team operated on all patients with similar operative techniques.
Results: in 2009-2022, 895 patients underwent LSG, 85 patients over 60 years old (Elderly Group), and a control group of 810 patients between 18 and 59 years old. The mean age was 64 vs. 39 years, p=0.00, the elderly group had a higher frailty index according to the Memorial Sloan Kettering Frailty Index, (mean, 1.68 vs. 0.77, p<0.01). The co-morbidities rates were significantly higher for the elderly group; Diabetes mellitus (%, 49 vs. 24, p<0.01), Hypertension (73 vs. 25, p<0.01), Obstructive sleep apnea (%, 21 vs. 10, p<0.01), Dyslipidemia (%, 66 vs 33, p<0.01). The perioperative course was similar for both groups in terms of 30-day and long-term complication rates.
For both groups, the co-morbidities improved or resolved in the vast majority of patients; DM (%, 100% vs 97% p=0.14), OSA (%, 100 vs 100 p=0.25), HTN (%, 93 vs 91, p=0.67) Dyslipidemia (%, 89 vs 93 p=0.11). In terms of Excess Weight Loss, the results were less favorable for the elderly group; 1 year (%, 74 vs 82, p<0.01), 2 years (%, 72 vs 81, p=0.02), 3 years (%, 64 vs 76, p<0.01) and 5 years (53 vs 70, p=0.02).
Conclusion: The Use of Sleeve gastrectomy for older patients is safe. Its positive impact on their comorbidities is notable and significant, although sustainable weight loss is not as high as in the younger group.
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