Is There an Upper Age Limit for Bariatric Surgery? Laparoscopic Gastric Bypass Outcomes in Septuagenarians
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ORIGINAL CONTRIBUTIONS
Is There an Upper Age Limit for Bariatric Surgery? Laparoscopic Gastric Bypass Outcomes in Septuagenarians Jacob B. Hammond 1 & Christopher J. Webb 1 & Venkata S. K. K. Pulivarthi 1 & David G. Pearson 1 & Kristi L. Harold 1 & James A. Madura II 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Upper age limits for bariatric surgery are questioned on the merits of increased complication rates in the elderly and questionable efficacy. This study evaluates outcomes of bariatric surgery in patients ≥ 70 years of age. Materials and Methods Retrospective review was performed of patients ≥ 70 years of age who underwent laparoscopic Roux-enY gastric bypass (RYGB) between 2001 and 2018. Primary endpoints were 30-day readmission, Clavien-Dindo grade III–V (CD III–IV) complications, and mortality. Secondary data included were weight loss, long-term outcomes, comorbidity resolution, hemoglobin A1C, and lipid panels. Results A total of 23 patients with an average age of 72 years (range 70–80 years) and mean BMI of 43.3 (range 37.3–56.0) were reviewed. Average length-of-stay was 2.4 days (range 1–6 days), with the only acute complication being aspiration pneumonia in one patient. Median follow-up was 69.3 weeks (range 9–875 weeks). One-year follow-up rate was 96%, during which no deaths or CD III-IV complications occurred. Subsequently, one patient experienced failure-to-thrive requiring temporary enteral nutrition. Average 1 year percent total weight loss (%TWL) was 29%, and this was maintained on subsequent follow-ups. Average 1 year percent excess weight loss (%EWL) was 60%, maintained long-term at 61%. Significant serum biochemical improvements included hemoglobin A1C (6.9 ± 1.4% to 5.6 ± 1.3%, p = 0.001), triglycerides (155 ± 49 mg/dL to 102 ± 41 mg/dL, p = 0.0003), and high-density lipoprotein cholesterol (48 ± 14 mg/dL to 58 ± 22 mg/dL, p = 0.004). Conclusion Laparoscopic RYGB is a safe and effective treatment for obesity and obesity-related comorbidities in septuagenarians. Keywords Bariatric surgery . Aged . Age factors . Postoperative complications . Treatment outcome . Weight loss
Introduction * James A. Madura, II [email protected] Jacob B. Hammond [email protected] Christopher J. Webb [email protected] Venkata S. K. K. Pulivarthi [email protected] David G. Pearson [email protected] Kristi L. Harold [email protected] 1
Department of Surgery, Division of General Surgery, Mayo Clinic, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA
Septuagenarians, persons aged 70–79 years, are a growing demographic. In the USA, a man or woman reaching age 65 can plan on living to ages 84 and 87 respectively [1, 2]. Even though people are living longer, latter years of life are often jeopardized by medical comorbidities. Obesity not only decreases life expectancy and quality of life but obesity-related comorbidities remain some of the leading causes of mortality [3, 4]. Laparoscopic Roux-en-Y gastric bypass (RYGB) as a treatment for obesi
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