Year 2019 / Volume 111 / Number 5
Original
The long-term benefits of bariatric surgery in elderly and super-obese populations

371-377

DOI: 10.17235/reed.2019.5917/2018

Linas Martinaitis, Carlota Tuero, Manuel Fortún Landecho, Javier A. Cienfuegos, Rafael Moncada, Fernando Rotellar, Camilo Silva, Gema Frühbeck, Víctor Valentí,

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.
Share Button
New comment
Comments
No comments for this article
References
1. Adams TD, Davidson LE, Litwin SE, et al. Weight and Metabolic Outcomes 12 Years after Gastric Bypass. New England Journal of Medicine 2017; 377: 1143-55.
2. De Luca M, Angrisani L, Himpens J, et al. Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obesity Surgery 2016; 26: 1659-96.
3. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. The Cochrane database of systematic reviews 2014 (8): CD003641.
4. Kashyap SR, Bhatt DL, Wolski K, et al. Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment. Diabetes Care 2013; 36: 2175-82.
5. Prachand VN, Ward M, Alverdy JC. Duodenal switch provides superior resolution of metabolic comorbidities independent of weight loss in the super-obese (BMI > or = 50 kg/m2) compared with gastric bypass. Journal of Gastrointestinal Surgery 2010; 14 :211-20.
6. Sturm R. Increases in morbid obesity in the USA: 2000-2005. Public Health 2007; 121: 492-6.
7. Abeles D, Kim JJ, Tarnoff ME, et al. Primary laparoscopic gastric bypass can be performed safely in patients with BMI >or= 60. Journal of the American College of Surgeons 2009; 208: 236-40.
8. Zerrweck C, Sepulveda EM, Maydon HG, et al. Laparoscopic gastric bypass vs sleeve gastrectomy in the super obese patient: early outcomes of an observational study. Obesity Surgery 2014; 24: 712-7.
9. Zak Y, Petrusa E, Gee DW. Laparoscopic Roux-en-Y gastric bypass patients have an increased lifetime risk of repeat operations when compared to laparoscopic sleeve gastrectomy patients. Surgical Endoscopy 2016; 30: 1833-8.
10. Mathus-Vliegen EM. Obesity and the elderly. Journal of Clinical Gastroenterology 2012; 46: 533-44.
11. Flegal KM, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. Jama 2012; 307: 491-7.
12. Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clinical interventions in aging 2015; 10: 1627-35.
13. Hubbard VS, Hall WH. Gastrointestinal surgery for severe obesity. Obesity Surgery 1991; 1: 257-65.
14. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc 1995; 27: 1692-7
15. Flum DR, Belle SH, King WC, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. The New England Journal of Medicine 2009; 361: 445-54.
16. Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study. Journal of Gastrointestinal Surgery 2012; 16 :35-44.
17. Contreras JE, Santander C, Court I, et al. Correlation between age and weight loss after bariatric surgery. Obesity Surgery 2013; 23: 1286-9.
18. Scozzari G, Passera R, Benvenga R, et al. Age as a long-term prognostic factor in bariatric surgery. Annals of Surgery 2012; 256: 724-8.
19. Giordano S, Victorzon M. Laparoscopic Roux-en-Y gastric bypass is effective and safe in over 55-year-old patients: a comparative analysis. World Journal of Surgery 2014; 38: 1121-6.
20. Elbahrawy A, Bougie A, Loiselle SE, et al. Medium to long-term outcomes of bariatric surgery in older adults with super obesity. Surgery for Obesity and Related Diseases 2018; 14:470-6.
21. Iannelli A, Schneck AS, Topart P, et al. Laparoscopic sleeve gastrectomy followed by duodenal switch in selected patients versus single-stage duodenal switch for superobesity: case-control study. Surgery for obesity and related diseases 2013; 9: 531-8.
22. Vicente C, Rabago LR, Ortega A, et al. Utilidad del balón intargástrico previo a cirugía bariátrica. Rev Esp Enferm Dig 2017; 109: 256-264.
23. López-Nava G, Bautista-Castaño I, Fernández-Corbelle JP, et al. Endoscopic sleeve gastroplasty (the Apollo method): a new approach to obesity management. Rev Esp Enferm Dig 2016; 108: 201-206.
24. Espinet Coll E, Nebredo Duran J, López-Nava Breviere G et al. Multicenter study on the safety of bariatric endoscopy. Rev Esp Enferm Dig 2017; 109: 350-357.
25. Daigle CR, Andalib A, Corcelles R, et al. Bariatric and metabolic outcomes in the super-obese elderly. Surgery for obesity and related diseases 2016; 12: 132-7.
26. Moon RC, Frommelt A, Teixeira AF, et al. Comparison of Banded Versus Non-banded Roux-en-Y Gastric Bypass: a Series of 1150 Patients at a Single Institution. Obesity Surgery 2018; (28): 212-217.
27. Shah K, Johnny Nergard B, Stray Frazier K, et al. Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome in patients with morbid obesity. Surgery for obesity and related diseases 2016; 12: 1449-56.
28. Otto M, Kautt S, Kremer M, et al. Handgrip strength as a predictor for post bariatric body composition. Obesity Surgery 2014; 24: 2082-8.
29. Celio AC, Wu Q, Kasten KR, et al. Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in super obese patients. Surgical Endoscopy 2017; 31: 317-23.
30. Li J, Lai D, Wu D. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy to Treat Morbid Obesity-Related Comorbidities: a Systematic Review and Meta-analysis. Obesity Surgery 2016; 26: 429-42.
31. Thereaux J, Czernichow S, Corigliano N, et al. Five-year outcomes of gastric bypass for super-super-obesity (BMI>/=60 kg/m(2)): a case matched study. Surgery for obesity and related diseases 2015; 11: 32-7.
32. Basso N, Casella G, Rizzello M, et al. Laparoscopic sleeve gastrectomy as first stage or definitive intent in 300 consecutive cases. Surgical Endoscopy 2011; 25:444-9.
Related articles

Digestive Diseases Image

A giant cause of recurrent fever

DOI: 10.17235/reed.2022.9340/2022

Digestive Diseases Image

A case of esophageal histoplasmosis mimicking carcinoma on endoscopy

DOI: 10.17235/reed.2023.9167/2022

Letter

Twisting of sleeve gastrectomy: two ways of clinic presentation

DOI: 10.17235/reed.2019.6366/2019

Original

Usefulness of an intra-gastric balloon before bariatric surgery

DOI: 10.17235/reed.2017.4624/2016

Citation tools
Martinaitis L, Tuero C, Fortún Landecho M, A. Cienfuegos J, Moncada R, Rotellar F, et all. The long-term benefits of bariatric surgery in elderly and super-obese populations. 5917/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1217 visits.
This article has been downloaded 268 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 11/09/2018

Accepted: 23/11/2018

Online First: 04/03/2019

Published: 07/05/2019

Article revision time: 66 days

Article Online First time: 174 days

Article editing time: 238 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology