Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years

Morbidity and mortality following laparoscopic sleeve gastrectomy (LSG) occur at acceptable rates, but its safety and efficacy in the elderly are unknown.

A retrospective review was performed of all patients aged >60 years who underwent LSG from 2008 to 2012. These patients were 1:2 matched, by gender and body mass index (BMI) to young patients, 18 < age < 50. Data analyzed included demographics, preoperative and postoperative BMI, postoperative complications, and improvement or resolution of obesity-related comorbidities.

Fifty-two morbid obese patients older than 60 years underwent LSG (mean age, 62.9 ± 0.3 years). These were matched to 104 young patients, age 18-50 years (mean age, 35.7 ± 0.8 years). Groups did not differ in male gender (44 vs. 43%, p = 0.9), preoperative BMI (42.6 ± 0.7 vs. 42.6 ± 0.6, p = 0.97), and length of follow-up (17 ± 2 vs. 22 ± 1.4 months, p = 0.06). Obesity-related comorbidities were significantly higher in the older group (96 vs. 65%, p < 0.001). Excess weight loss (EWL) was higher in the younger group (75 ± 2.4 vs. 62 ± 3%, p = 0.001). Older patients had a significantly higher rate of a concurrent hiatal hernia repair (23 vs. 1.9%, p < 0.001). Overall postoperative minor complication rate was higher in the older group (25 vs. 4.8%, p < 0.001). This included atrial fibrillation (9.5%), urinary tract infection (7%), trocar site hernia (4%), dysphagia, surgical site infection, bleeding, bowel obstruction, colitis, and nutritional deficiency (2%, each). No perioperative mortality occurred. Comorbidity resolution or improvement was comparable between groups (88 vs. 80%, p = 0.13).

LSG is safe and very efficient in patients aged >60, despite higher rates of perioperative comorbidities.