Publicaciones científicas

The long-term benefits of bariatric surgery in elderly and super-obese populations

15-may-2020 | Revista: Revista Española de Enfermedades Digestivas

Martinaitis L (1), Tuero C (2), Fortún Landecho M (3), Cienfuegos JA (2), Moncada R (4), Rotellar F (2), Silva C (5), Frühbeck G (5), Valentí V (2).

(1) Cirugía General y Digestiva, Clínica Universidad de Navarra, España.
(2) General Surgery, Clínica Universidad de Navarra, España.
(3) Department of Internal Medicine, Clínica Universidad de Navarra, España.
(4) Department of Anesthesiology, Clínica Universidad de Navarra.
(5) Department of Endocrinology, Clínica Universidad de Navarra, España.


PURPOSE:
to assess the long-term benefits of bariatric surgery in super-obese (body mass index [BMI] ≥ 50) and in elderly obese (age > 60 years) populations.

METHODS:
one hundred and twenty one patients who underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy in a university hospital were retrospectively subdivided into the following groups: BMI < 50 vs ≥ 50 and age < 60 vs ≥ 60 years. Weight loss, body composition and comorbidity outcomes were registered after one and six months and one, two, three and five years with 100%, 93%, 89%, 80%, 75% and 60% successful follow-up.

RESULTS:
the percentage of excess BMI loss (%EBMIL) was comparable between BMI groups and age groups and the difference in the long-term follow up was not statistically significant (p > 0.05). Complication rates, comorbidity resolution, reduction in body fat and increase in fat-free mass were comparable between BMI groups and age groups.

Gastric bypass resulted in a greater weight loss compared to sleeve gastrectomy. The % EBMIL was 65.2% vs 46.7% (p = 0.002), 65.8% vs 44.9% (p = 0.004), 64.4% vs 30.5% (p = 0.001), 55.6% vs 17.6% (p = 0.016) at one, two, three and five years postoperative, respectively. Similarly, in the super-obese group, weight loss was more pronounced after gastric bypass versus sleeve gastrectomy.

CONCLUSIONS:
bariatric surgery in super-obese and elderly populations is an effective and safe weight loss measure with a good comorbidity resolution in the long-term. Gastric bypass is superior to sleeve gastrectomy in terms of long-term weight loss and comorbidity resolution in all the groups investigated.

CITA DEL ARTÍCULO  Rev Esp Enferm Dig. 2019 May;111(5):371-377. doi: 10.17235/reed.2019.5917/2018