title: Midterm outcomes of gastric bypass for elderly (aged ≥ 60 yr) patients: a comparative study.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) is feasible for patients aged 60 years and older and is associated with a favorable early weight loss. However, data with longer follow-up in this age group are scarce. The present study compared weight loss and changes in co-morbidities 3 years after LRYGB between older patients (OP; ≥ 60 yr) and younger patients (YP; <60 yr). Data were collected prospectively in a single surgery university center (Paris, France).
  
  
  METHODS
  Between January 2004 and May 2011, 48 OP and 610 YP underwent LRYGB. Three-year outcomes were available for 42 (87.5%) OP and 480 (78.7%) YP; 42 OP undergoing LRYGB were matched with 84 YP for sex, preoperative body mass index (BMI), and presence of type 2 diabetes.
  
  
  RESULTS
  The sample was 81% female; preoperative BMI was 45.6 ± 6.4 kg/m² in OP versus 47.3 ± 5.2 kg/m² in YP patients (P = .12), and age was 62.6 ± 2.3 years in OP versus 42.9 ± 8.7 years in YP (P < .0001). The prevalence of coexisting conditions was comparable in both groups except for dyslipidemia (66.7% in OP versus 42.9% in YP; P = .01). At 3 years, percentage of weight loss and BMI change (kg/m²) was significantly lower in the OP group compared with YP (27.5 ± 8.6 versus 31.8 ± 12.1, P = .04; and -12.7 ± 4.9 versus -15.2 ± 6.2, P = .03). The rate of remission of hypertension was lower in OP than in YP (18.8% versus 53.8%; P = .002), as was that of both obstructive sleep apnea (60.6% versus 87.9%; P = .004) and dyslipidemia (42.9% versus 75.0%; P = .01).
  
  
  CONCLUSIONS
  At 3 years, despite less favorable impact on weight than for younger patients, LRYGB provided significant weight loss and remission of co-morbidities for patients aged > 60 years. Long-term trials are needed to better evaluate the benefit of bariatric surgery in aging obese patients.
authors.affiliation: Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Thereaux
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Poitou
authors.affiliation: Department of Nutrition, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Barsamian
authors.affiliation: Department of Nutrition, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.affiliation: Department of Nutrition, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France; Centre for Epidemiologic Cohort in Population (INSERM), Villejuif, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Czernichow
authors.affiliation: Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Boulogne, France. Electronic address: jl.bouillot@apr.aphp.fr.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bouillot
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015390:Gastric Bypass; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Elderly patients; Gastric bypass; Midterm outcome; Obesity