Laparoscopic adjustable gastric banding in patients > or =60 years old: is it worthwhile?
BACKGROUND
Laparoscopic adjustable gastric banding (LAGB) is an effective treatment for morbid obesity in younger patients, leading to improvements in related co-morbidities and quality of life. Currently, little is known how these improvements apply to older patients.


METHODS
A prospective review was conducted of patients > or =60 years old undergoing LAGB. Weight loss, complications, changes in Short Form-36 (SF-36) scores, and a comprehensive post-operative co-morbidity, medication and quality of life questionnaire were used to assess performance.


RESULTS
40 patients with mean age 65.8 years (range 60-72) and preoperative mean BMI of 42.2 kg/m(2) (range 33-54) underwent LAGB from February 2000 to September 2005. Mean excess weight lost at 2 years was 54%. 3 complications (7.5%) occurred (1 slippage and 2 access-port infections). There were no perforations, erosions or deaths. After a mean postoperative interval of 27 months, SF-36 scores improved significantly in 4 of 8 components and exceeded age-matched population controls in 3 components. Co-morbidity improvement was reported in 80% of patients with diabetes, 79% with dyslipidemia, 75% with obstructive sleep apnea, 72% with heartburn, 69% with hypertension, 60% with musculoskeletal pain, and 56% with anxiety/depression. Medication requirements reduced or ceased in 66% who required musculoskeletal analgesics, 43% of diabetics, 33% using bronchodilators, and 29% with hypertension. Sleep improved in 48%, self-esteem increased in 70%, and 72% had a better outlook on life. 82% were happy that they had undergone LAGB, and 91% would recommend LAGB to other older people.


CONCLUSIONS
LAGB offers safe and effective weight loss, and improvement in co-morbidities and in quality of life in morbidly obese patients aged > or =60 years.
Taylor
Craig John
CJ
Obesity Surgery Centre, John Flynn Hospital, Queensland, Australia.
Layani
Laurent
L
D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000523:psychology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012307:Risk Factors; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss