title: Bariatric surgery in elderly patients. A comparison between gastric banding and sleeve gastrectomy with five years of follow up.
abstract: BACKGROUND
  The prevalence of obesity is rising progressively, even among elderly patients. Many studies investigated about safety and efficacy of bariatric surgery among aged obese patients. The objective of this review is to assess the benefits relative to risks of weight loss that may be obtained by performing two common bariatric procedures in obese elderly patient.
  
  
  METHODS
  We retrospectively evaluated 10 morbid obese patients older than 60 years reaching 5 years of follow up who respectively underwent Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic Adjustable Gastric Banding (LAGB). Eventual changes in comorbidities, weight loss, EWL% were investigated.
  
  
  RESULTS
  Although LSG patients required a longer postoperative hospital stay than LAGB patients (p < 0.001), both procedures have shown to be safe and equally effective for weight loss achievement in elderly patients. Whereas all patients showed comorbidities resolution, no significant difference in weight loss between LAGB group and LSG group was found at 1 year (EWL% p = 0.87; BMI p = 0.32), 3 years (EWL% p = 0.62; BMI p = 0.79) and 5 years (EWL% p = 0.52; BMI p = 0.46) of follow up.
  
  
  CONCLUSIONS
  Bariatric surgery is safe and effective to reach obesity related comorbidities resolution among elderly obese patients. Both LAGB and LSG determine a weight loss lesser than observed in a standard bariatric population. In this study LSG is significantly less cost effective than LAGB. Larger studies with longer follow up are however needed to evaluate the real impact of bariatric surgery on weight loss, resolution of comorbidities and improvement of quality of life in elderly obese patients.
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: mario.musella@unina.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Musella
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: milone.marco@alice.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Milone
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: paola_maietta@hotmail.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Maietta
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: biancopaolo@virgilio.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bianco
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: guidocoretti@gmail.com.
authors.forename: Guido
authors.initials: G
authors.lastname: Coretti
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: anna.pisapia@tiscali.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Pisapia
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: mrchi6@hotmail.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Gaudioso
authors.affiliation: Advanced Biomedical Sciences Department - General Surgery, "Federico II" University, Naples, Italy. Electronic address: francesco.milone@unina.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Milone
mesh_terms: D000368:Aged; D050110:Bariatric Surgery / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000191:economics / Q000379:methods*; D015391:Gastroplasty / Q000191:economics / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011184:Postoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Elderly patients; Laparoscopic gastric banding; Morbid obesity; Sleeve gastrectomy