title: Postoperative Outcomes of Laparoscopic Bariatric Surgery in Older Obese Patients: a Matched Case-Control Study.
abstract: Laparoscopic bariatric surgery (LBS) in older obese patients remains debated regarding postoperative outcomes.
  
  
  
  The aim of this case-control study is to evaluate global results of LBS in patients ≥60 years (yr) with a matched case control study.
  
  
  
  All patients ≥60 years who benefited from LBS in our center between January 2009 and January 2014 were included in this retrospective study. They were matched (1:2) to patients <40 and 40-59 years on BMI, surgical procedure and year, and history of previous LBS. Postoperative complications in the first 90 days following LBS, micronutrient and mineral deficiencies, and Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed.
  
  
  
  Fifty-five patients ≥60 year (40 sleeve gastrectomy, 14 one anastomosis gastric bypass, 1 gastric bypass revision) were matched to patients <40 year and patients 40-59 year (n = 55 each). Patients ≥60 year presented more obesity-related comorbidities at baseline. Except for bleeding complications (P = 0.01), no difference in major complication rate was observed (P = 0.43). At 24 months, %EWL was lower in older patients compared to others (76.3, 82.2 and 89.7, respectively, P = 0.009). Iron and vitamin B12 deficiencies were less prevalent in patients ≥60 year After a mean follow-up of 27 months, BAROS score (filled in by 82% of patients) was lower in patients ≥60 years (P = 0.01).
  
  
  
  Despite less weight loss, postoperative complications rate, and lower BAROS results, LBS keeps an acceptable benefit-risk balance in selected older patients and should not be rejected on the sole argument of age. Additional studies are needed to assess the long-term benefits of LBS in older patients.
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, Hôpital Pontchaillou, Rennes, France. damien.bergeat@chu-rennes.fr.|Université de Rennes 1, Rennes, France. damien.bergeat@chu-rennes.fr.|UMR NuMeCan (Nutrition, Métabolismes, Cancer), INRA, ALICE, St Gilles, France. damien.bergeat@chu-rennes.fr.
authors.forename: Damien
authors.initials: D
authors.lastname: Bergeat
authors.affiliation: Service de Chirurgie Digestive, Hôpital Yves-le-Foll, Saint Brieuc, France.
authors.forename: David
authors.initials: D
authors.lastname: Lechaux
authors.affiliation: Service de Chirurgie Digestive, Hôpital Yves-le-Foll, Saint Brieuc, France.
authors.forename: Adil
authors.initials: A
authors.lastname: Ghaina
authors.affiliation: Université de Rennes 1, Rennes, France.|UMR NuMeCan (Nutrition, Métabolismes, Cancer), INRA, ALICE, St Gilles, France.|Unité de Nutrition, Service d'Endocrinologie-Diabétologie-Nutrition, INSERM U991, CHU Rennes, Université Rennes 1, F-35000, Rennes, France.
authors.forename: Ronan
authors.initials: R
authors.lastname: Thibault
authors.affiliation: Service de Chirurgie Digestive, Hôpital Yves-le-Foll, Saint Brieuc, France.
authors.forename: Vianney
authors.initials: V
authors.lastname: Bouygues
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015390:Gastric Bypass / Q000379:methods; D006299:Health Services for the Aged; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: BAROS; Bariatric surgery; Laparoscopic one anastomosis gastric bypass; Laparoscopic sleeve gastrectomy; Mineral and micronutrient deficiencies; Obesity-related comorbidities; Older patients; Quality of life