title: Long-term outcome after laparoscopic sleeve gastrectomy in patients over 65 years old: a retrospective analysis.
abstract: BACKGROUND
  Bariatric surgery has been proven to be a safe and effective treatment for obesity with BMI (body mass index) reduction, and resolution or lowering of obesity-related co-morbidities. The relative age limit for bariatric surgery has gradually been increased to 60 years of age and above.
  
  
  OBJECTIVE
  The aim of this study was to assess the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) performed in older patients (≥65 years old).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Between May 1, 2007 and November 30, 2013, 30 consecutive patients≥65 years old were included in this retrospective study of our prospectively collected bariatric database.
  
  
  RESULTS
  A total of 27 (90%) primary LSG and 3 revisional LSG (10%) were performed. Mean patient age was 67.2 (range: 65-74) years, and mean preoperative BMI (±standard deviation [SD]) was 44.1±5.6 kg/m2. Thirty-day morbidity included 3 cases of self-limiting nausea and vomiting and 1 case of gastric sleeve stenosis necessitating conversion to gastric bypass. No mortality reported. The overall mean percentage of excess weight loss (±SD) and percentage of total weight loss (±SD) at 12 months were 53.8±19.8 and 23.9±8.4; 52.9±21.8 and 24±9.9 at 36 months, respectively. No patients were lost to follow-up but 5 were excluded because they underwent revisions. Age-adjusted mixed model analyses revealed that baseline BMI (P = .018), BMI>45 kg/m2(P = .001), and having diabetes (P = .030) were associated with excess weight loss<50% across follow-up.
  
  
  CONCLUSIONS
  LSG seems to be effective and safe for patients≥65 years old. Obesity related co-morbidities have improved across follow-up. BMI>45 kg/m2and diabetes is associated with insufficient weight loss or weight regain.
authors: Department of Surgery, Division of Bariatric Surgery, Hôpital du Sacré-Coeur de Montréal, University of Montréal, Montréal, Québec, Canada.
authors: Fabio
authors: F
authors: Garofalo
authors: Department of Surgery, Division of Bariatric Surgery, Hôpital du Sacré-Coeur de Montréal, University of Montréal, Montréal, Québec, Canada.
authors: Ronald
authors: R
authors: Denis
authors: Department of Surgery, Division of Bariatric Surgery, Hôpital du Sacré-Coeur de Montréal, University of Montréal, Montréal, Québec, Canada.
authors: Radu
authors: R
authors: Pescarus
authors: Department of Surgery, Division of Bariatric Surgery, Hôpital du Sacré-Coeur de Montréal, University of Montréal, Montréal, Québec, Canada.
authors: Henri
authors: H
authors: Atlas
authors: Centre de Médecine Comportementale de Montréal, Hôpital du Sacré-Cœur, Montréal, University of Montréal, Montréal, Québec, Canada.
authors: Simon L
authors: SL
authors: Bacon
authors: Department of Surgery, Division of Bariatric Surgery, Hôpital du Sacré-Coeur de Montréal, University of Montréal, Montréal, Québec, Canada. Electronic address: pierre.y.garneau@sympatico.ca.
authors: Pierre
authors: P
authors: Garneau
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000517:prevention & control; D050171:Dyslipidemias / Q000150:complications / Q000517:prevention & control; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D015390:Gastric Bypass / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000401:mortality / Q000601:surgery*; D061646:Operative Time; D061214:Patient Safety; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000517:prevention & control; D013531:Surgicenters / Q000706:statistics & numerical data; D016896:Treatment Outcome; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology
keywords: Elderly patients; Laparoscopy; Sleeve gastrectomy