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

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

doi:10.5114/wiitm.2019.81450

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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1/2020
vol. 15

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Bariatric surgery

abstract:

Original paper

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

Natalia Dowgiałło-Wnukiewicz

¹

,

Michal R. Janik

²

,

Pawel Lech

¹

,

Piotr Major

^{3, 4}

,

Michał Pędziwiatr

^{3, 4}

,

Piotr K. Kowalewski

²

,

Maciej Walędziak

²

,

Michał Wysocki

^{3, 4}

,

Maciej Michalik

¹

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
2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland

Videosurgery Miniinv 2020; 15 (1): 123–128

DOI: https://doi.org/10.5114/wiitm.2019.81450

Online publish date: 2019/01/22

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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 BMI 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.

keywords:

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

Natalia Dowgiałło-Wnukiewicz 1 , Michal R. Janik 2 , Pawel Lech 1 , Piotr Major 3, 4 , Michał Pędziwiatr 3, 4 , Piotr K. Kowalewski 2 , Maciej Walędziak 2 , Michał Wysocki 3, 4 , Maciej Michalik 1

older age, elderly, sleeve gastrectomy, bariatric surgery

Natalia Dowgiałło-Wnukiewicz

¹

,

Michal R. Janik

²

,

Pawel Lech

¹

,

Piotr Major

^{3, 4}

,

Michał Pędziwiatr

^{3, 4}

,

Piotr K. Kowalewski

²

,

Maciej Walędziak

²

,

Michał Wysocki

^{3, 4}

,

Maciej Michalik

¹