Sleeve Gastrectomy Associated With Fewer Complications Than Gastric Bypass in Elderly Patients
By Kerry Young
OXON HILL, Md -- November 4, 2017 -- A review of records of elderly patients found that those who underwent sleeve gastrectomy were less likely to have certain complications than those who underwent minimally invasive Roux-en-Y gastric bypass (RYGB), according to a study presented here at Obesity Week 2017, the joint Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS) and The Obesity Society (TOS).
The retrospective analysis looked at data from 16,568 patients aged older than 60 years who underwent either laparoscopic/robotic sleeve gastrectomy or RYGB.
Tallal Zeni, MD, Michigan Bariatric Institute, Livonia, Michigan, and colleagues used reports from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) registry for the study.
Results showed that the all-morbidity rate was lower for sleeve gastrectomy than RYGB (5.81% vs 10.61%; P< .001), although there was no difference in mortality rates (0.38% vs 0.26%; P = .221).
Those who underwent the sleeve procedure also were less likely to have the following complications compared with the bypass group: surgical site infection (0.61% vs 1.74%; P< .001), pneumonia (0.32% vs 0.87%; P< .001), anastomotic leak (0.30% vs 0.56%; P = .017), anastomotic ulcer (0.03% vs 0.31%; P< .001), stricture (0.15% vs 0.63%; P = .03), obstruction (0.06% vs 0.65%; P< .001), and bleeding (0.50 vs 1.14%; P = .24).
“Bariatric surgery is safe in the elderly, even patients who are aged 70 years and older,” said Dr. Zeni, suggesting that further research is needed to evaluate long-term weight loss in the elderly.
However, the results of the study should boost confidence for obese elderly patients who are thinking about undergoing bariatric surgery, he added. The number of older people undergoing bariatric surgery already is on the rise, increasing from 2.7% in 1999-2005 to 10.1% in 2009-2013 to 12.4% and 12.4% based on data from the current study.
[Presentation title: Minimally Invasive Roux-en-y Gastric Bypass Versus Sleeve Gastrectomy in the Elderly: Results From the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). A129]