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Rev Esp Enferm Dig. 2019 Mar 4;111. doi: 10.17235/reed.2019.5917/2018. [Epub ahead of print]

The long-term benefits of bariatric surgery in elderly and super-obese populations.

Author information

1
Cirugía General y Digestiva, Clínica Universidad de Navarra, España.
2
General Surgery, Clínica Universidad de Navarra, España.
3
Department of Internal Medicine, Clínica Universidad de Navarra, España.
4
Department of Anesthesiology, Clínica Universidad de Navarra.
5
Department of Endocrinology, Clínica Universidad de Navarra, España.

Abstract

PURPOSE:

to assess the long-term benefits of bariatric surgery in super-obese (body mass index [BMI] ≥ 50) and in elderly obese (age > 60 years) populations.

METHODS:

one hundred and twenty one patients who underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy in a university hospital were retrospectively subdivided into the following groups: BMI < 50 vs ≥ 50 and age < 60 vs ≥ 60 years. Weight loss, body composition and comorbidity outcomes were registered after one and six months and one, two, three and five years with 100%, 93%, 89%, 80%, 75% and 60% successful follow-up.

RESULTS:

the percentage of excess BMI loss (%EBMIL) was comparable between BMI groups and age groups and the difference in the long-term follow up was not statistically significant (p > 0.05). Complication rates, comorbidity resolution, reduction in body fat and increase in fat-free mass were comparable between BMI groups and age groups. Gastric bypass resulted in a greater weight loss compared to sleeve gastrectomy. The % EBMIL was 65.2% vs 46.7% (p = 0.002), 65.8% vs 44.9% (p = 0.004), 64.4% vs 30.5% (p = 0.001), 55.6% vs 17.6% (p = 0.016) at one, two, three and five years postoperative, respectively. Similarly, in the super-obese group, weight loss was more pronounced after gastric bypass versus sleeve gastrectomy.

CONCLUSIONS:

bariatric surgery in super-obese and elderly populations is an effective and safe weight loss measure with a good comorbidity resolution in the long-term. Gastric bypass is superior to sleeve gastrectomy in terms of long-term weight loss and comorbidity resolution in all the groups investigated.

PMID:
30829531
DOI:
10.17235/reed.2019.5917/2018
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