title: BARIATRIC SURGERY IN THE ELDERLY: RESULTS OF A MEAN FOLLOW-UP OF FIVE YEARS.
abstract: BACKGROUND
  Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; it is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population.
  
  
  OBJECTIVE
  To evaluate the results of surgical treatment of obesity in patients over 60 years, followed for an average period of five years.
  
  
  METHODS
  This was a retrospective study evaluating 46 patients, 60 years or older, who underwent surgical treatment of obesity, by conventional gastric bypass technique (laparotomy). The average age was 64 years (60-71), mean BMI of 49.6 kg/m2 (38-66), mean follow-up of 5.9 years; 91% of patients were hypertensive, 56% diabetics and 39% had dyslipidemia.
  
  
  RESULTS
  The incidence of complications (major and minor) in patients under 65 years was 26% and over 65 years 37% (p=0.002). There were no deaths in the group with less than 65 years and there were two deaths (12.5%) over 65 years. The average loss of overweight over 65 years or less was 72% vs 68% (p=0.56). There was total control of the diabetes mellitus in 77% and partial in 23%, with no difference between groups. There was improvement in arterial hypertension in 56% of patients, also no difference between groups. The average LDL levels did not differ between the pre and postoperative (106 mg/dl to 102 mg/dl), an increase of HDL (56 mg/dl to 68 mg/dL) and reduced triglyceride levels (136 mg/dl to 109 mg/dl). There was no statistical difference in the variation of the cholesterol fractions and triglycerides between the groups. Two patients in the group with less than 65 years died in late follow-up, of brain tumor and pneumonia, three and five years after bariatric surgery, respectively.
  
  
  CONCLUSIONS
  Surgical morbidity and mortality were higher in patients over 65 years, and this group had the same benefits observed in patients lower 65 years for weight loss and comorbidities control.
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Denis
authors.initials: D
authors.lastname: Pajecki
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Marco Aurelio
authors.initials: MA
authors.lastname: Santo
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Henrique Dametto Giroud
authors.initials: HD
authors.lastname: Joaquim
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Morita
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Riccioppo
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: de Cleva
authors.affiliation: Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000368:Aged; D050110:Bariatric Surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors