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.
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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.
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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


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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


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