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Safety and efficacy of laparoscopic adjustable gastric banding in patients aged seventy and older.

AbstractBACKGROUND:
Life expectancy is increasing, with more elderly people categorized as obese. The objective of this study was to assess the effects of laparoscopic adjustable gastric banding (LAGB) on patients aged ≥ 70 years.
METHODS:
This was a retrospective analysis of patients aged ≥ 70 years who underwent LAGB at our university hospital between 2003 and 2011. The data included age, weight, body mass index (BMI), and percentage excess weight loss (%EWL) obtained before and after gastric banding. Operative data, length of stay, postoperative complications, and resolution of co-morbid conditions were also analyzed.
RESULTS:
Fifty-five patients aged ≥ 70 years (mean 73 years) underwent gastric banding between 2003 and 2012. Mean preoperative weight and BMI were 123 kilograms and 45 kg/m(2), respectively. On average, each patient had 4 co-morbidities preoperatively, with hypertension (n = 49; 86%), dyslipidemia (n = 40; 70%), and sleep apnea (n = 31; 54%) being the most common. Mean operating room (OR) time was 49 minutes, with all patients discharged within 24 hours. There was 1 death at 4 years from myocardial infarction, no intensive care unit admissions, and no 30-day readmissions. Mean %EWL at 1, 2, 3, 4, and 5 years was 36 (± 12.7), 40 (± 16.4), 42 (± 19.2), 41 (± 17.1), 50 (± 14.9), and 48 (± 22.6), respectively. Follow-up rates ranged from 55/55 (100%) at 6 months to 7/9 (78%) of eligible patients at 5 years and 2/2 (100%) at 8 years. Complications included 1 band slip at year 5, 1 band removed for intolerance, and 1 port site hernia. The resolution of hypertension, dyslipidemia, sleep apnea, lower back pain, and non-insulin-dependent diabetes was 27%, 28%, 35%, 31%, and 35%, respectively.
CONCLUSIONS:
LAGB as a primary treatment for obesity in carefully selected patients aged ≥ 70 can be well tolerated and effective with moderate resolution of co-morbid conditions and few complications.
AuthorsJohn J Loy, Heekoung A Youn, Bradley Schwack, Marina S Kurian, George A Fielding, Christine J Ren-Fielding
JournalSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2014 Mar-Apr Vol. 10 Issue 2 Pg. 284-9 ISSN: 1878-7533 [Electronic] United States
PMID24582414 (Publication Type: Journal Article)
CopyrightCopyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Topics
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Gastroplasty (methods)
  • Humans
  • Laparoscopy
  • Life Expectancy
  • Male
  • Obesity, Morbid (surgery)
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss

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