Long-teini outcome after laparoscopic sleeve gastrectomy in patients over 65 years old: a retrospective analysis

Background: Bariatric surgery has been proven to be a safe and effective treatment for obesity with BMI (body mass index) reduction, and resolution or lowering of obesity-related co-morbidities. The relative age limit for bariatric surgery has gradually been increased to 60 years of age and above. Objectives: The aim of this study was to assess the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) performed in older patients (>= 65 years old). Setting: University hospital. Methods: Between May 1, 2007 and November 30, 2013, 30 consecutive patients >= 65 years old were included in this retrospective study of our prospectively collected bariatric database. Results: A total of 27 (90%) primary LSG and 3 revisional LSG (10%) were performed. Mean patient age was 67.2 (range: 65-74) years, and mean preoperative BMI (+/- standard deviation [SD]) was 44.1 +/- 5.6 kg/m(2). Thirty-day morbidity included 3 cases of self-limiting nausea and vomiting and 1 case of gastric sleeve stenosis necessitating conversion to gastric bypass. No mortality reported. The overall mean percentage of excess weight loss (+/- SD) and percentage of total weight loss (+/- SD) at 12 months were 53.8 +/- 19.8 and 23.9 +/- 8.4; 52.9 +/- 21.8 and 24 +/- 9.9 at 36 months, respectively. No patients were lost to follow-up but 5 were excluded because they underwent revisions. Age-adjusted mixed model analyses revealed that baseline BMI (P = .018), BMI > 45 kg/m(2) (P = .001), and having diabetes (P = .030) were associated with excess weight loss <50% across follow-up. Conclusion: LSG seems to be effective and safe for patients >= 65 years old. Obesity related co-morbidities. have improved across follow-up. BMI > 45 kg/m(2) and diabetes is associated with insufficient weight loss or weight regain. (C) 2017 American Society for Metabolic and Bariatric Surgery. All rights reserved.