Gastric Bypass in Older Patients: Complications, Weight Loss, and Resolution of Comorbidities at 2 Years in a Matched Controlled Study

Abstract

Background: Roux-en-Y gastric bypass (RYGB) has recently been authorized for use in older patients. The objective of this single-center study was to evaluate 2-year weight loss in patients ≥60 years compared with younger matched patients undergoing RYGB. Secondary aims were to record complications and the resolution of comorbidities in a 2-year follow-up.

Methods: Of 722 patients with at least 2 years follow-up data, 48 elderly patients were matched with 92 young (<40 years) and 96 middle-aged (40-59 year) patients, according to sex, baseline body mass index, and date of surgery. Weight loss, remission of comorbidities, death, and early (30-day) and 2-year complication rates were compared.

Results: There were three deaths in the elderly group and none in the other groups. The early complication rate was not significantly different in the elderly group (17.8 %) compared with the young (11.5 %, p = 0.637) and middle-aged (13.7 %, p = 1.000) groups. The 2-year complication rates were not significantly different in the elderly group (9.3 %) compared with the young (23.5 %, p = 0.107) and middle-aged (13.2 %, p = 1.000) groups. The 2-year weight loss was lower in the elderly group (31.8 ± 7.2 %; p < 0.001) than in the young group (38.3 ± 6.9 %) but was not significantly different from that in the middle-aged group (34.4 ± 8.0 %; p = 0.145). Remission rates for diabetes and obstructive sleep apnea were lower in the elderly than in the two younger groups.

Conclusion: After bariatric surgery, major weight loss was observed in patients older than 60, but remission of metabolic comorbidities was less marked than in younger subjects.

Keywords: Diabetes; Hypertension; Obesity surgery; Obstructive sleep apnea; Remission.