Elie K Chouillard, MD, PhD1, Salman Alsabah, MD2, Georges Khoury, MD3. 1PARIS POISSY MEDICAL CENTER, 2AMIRI Hospital Kuwait City, 3RIZK Hospital Beirut
In France, age over 60 years has traditionally been considered as a relative contraindication to bariatric surgery. However, many reports showed that surgery for morbid obesity has favorable results. We compared early outcome of laparoscopic sleeve gastrectomy (LSG) in patients over 60 years on a case-control basis with < 40 years patients.
From November 2005 to November 2013, 530 patients underwent laparoscopic sleeve gastrectomy. Of these, 70 patients (13.2 %) were > 60 years. Outcomes in terms of perioperative complications, short-term and medium-term weight loss, remission or improvement of co-morbidities and medication requirements were extracted from our prospective database. The study group was retrospectively matched with 70 patients < 40 years old who had LSG during the study period. Matching criteria included BMI, number of preoperative comorbidities, and the ASA score.
Ninty-days mortality was 0% in both groups. Operative morbidity rate was similar in both groups (7.1 % versus 10 % according to Clavien-Dindo classification) (p>0.05). At 6 months postsurgery, older patients had lost 52 % percent of excess weight compared to 53 % in the younger group (P = 0. 8). At 12 months, Excess weight loss was 55% (Group >60 years) versus 68% (Group <40 years), respectively (p = 0.025). The comorbidities pattern was identical in both groups. Quality of life scores were comparable in both groups.
LSG is a safe and effective treatment for morbid obesity in patients > 60 years old. No additional mortality or morbidity was induced by age. Daily medication requirements and co-morbidities decrease significantly and identically in boths groups.