title: Gastric bypass for morbid obesity in patients 50 years or older: is laparoscopic technique safer?
abstract: Some physicians have considered age > or = 50 years as a relative contraindication for bariatric surgery. Recent reports demonstrated the safety and efficacy of Roux-en-Y gastric bypass (RYGB) in this patient subgroup, but comparisons between laparoscopic technique (LT) and open technique (OT) have not been reported. A review of 52 patients > or = 50 years old who underwent RYGB between January 1999 and April 2002 was conducted. Demographics, operative data, and outcomes were assessed. Preoperative and postoperative renal and hepatic functions, electrolytes, anemia studies, and hematology results were compared. Patients were divided into LT and OT groups and operative outcomes were compared. The percentage of excess body weight loss was 66 +/- 4 per cent at mean follow-up of 12 months. Blood samples drawn after a mean of 8 +/- 2 months revealed no postoperative metabolic alterations. RYGB resulted in a reduction of the number of patients with hyperglycemia, hypertension, degenerative joint disease, gastroesophageal reflux disease, and continuous positive airway pressure-dependent sleep apnea (P < 0.05). The LT resulted in fewer intensive care unit admissions and shorter length of stay. RYGB is safe and well tolerated in patients > or = 50 years resulting in no renal, hepatic, or electrolytic alterations. Weight loss and control of obesity-related comorbidities are satisfactory. The LT results in fewer intensive care unit admissions and shorter length of stay than the OT.
authors.affiliation: Emory Endosurgery and Bariatrics Unit, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Gonzalez
authors.forename: Edward
authors.initials: E
authors.lastname: Lin
authors.forename: Samer G
authors.initials: SG
authors.lastname: Mattar
authors.forename: Kota R
authors.initials: KR
authors.lastname: Venkatesh
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
mesh_terms: D000367:Age Factors; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015431:Weight Loss