Amlish B Gondal, MD, Matthew E Mobily, MD, MPH, Iman Ghaderi, MD, MSc, MHPE. University of Arizona
Introduction: In the United States, more than 10% of bariatric procedures in academic centers are performed in elderly patients. Higher morbidity and mortality rates have been described in patients above 65 years old. However, there is limited data about the relative safety of robotic assisted sleeve gastrectomy (RA-SG) and Roux-en-Y gastric bypass (RA-RYGB) in this subset of patients. We aimed to compare 30-day safety of these procedures in geriatric patients.
Methods: Using current procedural terminology codes, RA-SG and robotic assisted RA-RYGB procedures performed on patients greater than 65 years of age were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) participant use file 2016. Demographic data, baseline comorbidities, perioperative data and 30-day outcomes were examined. Outcomes of interest were summarized with descriptive statistics and two tailed analyses were performed using chi-squares for categorical variables (reported as proportions) and t-tests for continuous variables (reported as mean ± SD).
Results: A total of 698 patients were identified; 61.9% patients underwent RA-SG whereas 38.1% underwent RA-RYGB. Mean age was 68.4±2.83, mean body mass index was 42.7±7.44, 71.8% were female, 85% were white, and 82.5% patients were classified as ASA class III.
Both the RA-SG group and RA-RYGB group were similar in baseline characteristics except patients who underwent were RA-RYGB had higher prevalence of gastroesophageal reflux disease (54% vs. 43%, p=0.002) and patients who underwent RA-SG had higher prevalence of hypertension (21% vs. 14%, p=.02).
Patients who underwent RA-RYGB had a longer length of hospital stay, operative time, reoperation and readmission rates within 30 days after surgery (Table 1). Major organ system morbidity was similar in both groups. There were no deaths in either group.
Conclusion: Robotic assisted bariatric surgery in patients 65 years and older appears safe. However, robotic assisted gastric bypass is associated with higher rates of reoperation and readmission. Prospective data is needed to evaluate long-term efficacy of these procedures in the elderly.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95797
Program Number: P153
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
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