Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass in Elderly Bariatric Patients: Safety and E
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ORIGINAL CONTRIBUTIONS
Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass in Elderly Bariatric Patients: Safety and Efficacy—a Systematic Review and Meta-analysis Sachin S. Shenoy 1 & Andrew Gilliam 2 & Ahmed Mehanna 3 & Venkatesh Kanakala 4 & Gopinath Bussa 5 & Talvinder Gill 5 & Katherine Sanderson 6 & Y. K. S. Viswanath 4,7 & Venkatesh Shanmugam 5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Obesity is a chronic disease due to excess fat storage, a genetic predisposition, and environmental contribution where surgery offers a viable treatment option. The surgical treatment of obesity in the elderly population (> 55 years) remains controversial. Purpose To evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in elderly bariatric patients. Materials and Methods Data was sourced from MEDLINE, EMBASE, CINAHL, PubMed, and Cochrane databases for peerreviewed, randomized controlled trials, and observational studies in the English language were searched from the year 1991 until 2019. From the extracted data, early and late procedural complications and mortality were used as safety outcomes. Weight loss was the primary outcome for effectiveness while the resolution of obesity-related comorbidities was included as secondary outcomes. The Review Manager (Rev Man 5.3)™ software was used for statistical analysis. Results Of the forty-one screened studies, nine studies were included in the final analysis. There was no difference between LSG and LRYGB regardingearlycomplicationsandmortality3.6%versus5.8%(p = 0.15)and0.1%versus0.8%(p = 0.27).PatientswhounderwentLRYGBhad morelatecomplicationscomparedwiththosewhounderwentLSG(0.07%and0.03%,p = 0.001).Therewasnodifferenceintermsofweightlossat the end of 1year. Patients whounderwentLRYGB had abetterresolution ofobesity-related comorbidities,notstatistically significant. Conclusion LRYGB has better efficacy when compared with LSG. However, high-risk elderly patients should be considered for LSG given the lesser morbidity and comparable efficacy with LRYGB. Keywords Elderly . Laparoscopic sleeve gastrectomy . Laparoscopic gastric bypass . Safety . Efficacy
* Y. K. S. Viswanath [email protected]
Venkatesh Shanmugam [email protected]
Sachin S. Shenoy [email protected]
1
Department of Surgery, County Durham and Darlington NHS Foundation Trust, Darlington, UK
Andrew Gilliam [email protected]
2
County Durham and Darlington NHS Foundation Trust, Darlington, UK
Ahmed Mehanna [email protected]
3
Department of Surgery, James Cook University Hospital, Middlesbrough, UK
Venkatesh Kanakala [email protected]
4
James Cook University Hospital, South Tees Hospital NHS Foundation Trust, Middlesbrough, UK
Gopinath Bussa [email protected]
5
North Tees and Hartlepool NHS Foundation Trust, Stockton on Tees, UK
Talvinder Gill [email protected]
6
SHSC Women and Children’s Health/Public Health, Teesside Unive
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