title: Sleeve gastrectomy in the elderly: a safe and effective procedure with minimal morbidity and mortality.
abstract: BACKGROUND
  Previously, we demonstrated the safety and efficacy of laparoscopic gastric bypass surgery in patients over 65 years of age. The aim of this study is to demonstrate the safety and efficacy of this procedure as a final step for treatment of morbid obesity in the same population.
  
  
  METHODS
  A retrospective review of a prospectively collected database was performed. Between 2004 and 2010, a total of 35 patients age 60 and greater were analyzed from a total of 512 sleeve gastrectomy patients. Demographics, preoperative body mass index, complications, and excess weight loss were recorded and compared to bougie size and follow-up in months. Mean age was 66.3 years (range, 60-79 years), mean body mass index was 46.3 kg/m(2) (range, 33.7-77.6 kg/m(2)), and mean excess weight loss was 148.49 lb (range, 72-252 lb).
  
  
  RESULTS
  One patient (2.8 %) had an incidental colotomy as a result of trocar insertion, one patient (2.0 %) bled, and one patient (2.8 %) had small-bowel enterotomy. Overall, morbidity was 8.4 % with no mortality. Mean percent excess weight loss results for bougie size 52 were 28, 34, 26, 18, and 27 % at 3, 6, 12, 24 and 48 months, respectively; for bougie size 46 were 31, 57, 64, 62, and 82 % at 3, 6, 12, 24 and 48 months, respectively; and bougie size 38 were 37, 50, 55, and 56 % at 3, 6, 12 and 24 months, respectively.
  
  
  CONCLUSIONS
  Laparoscopic sleeve gastrectomy is an effective procedure for morbidly obese patients age 60 and greater that can be performed safely.
authors.affiliation: Department of General Surgery and Section of Minimally Invasive Surgery & Bariatric Surgery, Cleveland Clinic Florida, The Bariatric and Metabolic Institute, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA.
authors.forename: Flavia C
authors.initials: FC
authors.lastname: Soto
authors.forename: Vicente
authors.initials: V
authors.lastname: Gari
authors.forename: Javier R
authors.initials: JR
authors.lastname: de la Garza
authors.forename: Samuel
authors.initials: S
authors.lastname: Szomstein
authors.forename: Raul J
authors.initials: RJ
authors.lastname: Rosenthal
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects* / Q000401:mortality*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D061646:Operative Time; D018579:Patient Selection; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss