Bariatric Surgery in the Elderly Patient: Safety and Short-time Outcome. A Case Match Analysis

Vinan-Vega, Myrian; Vico, Tamara Díaz; Elli, Enrique F.

doi:10.1007/s11695-018-03633-2

Cited by 30 publications

(10 citation statements)

References 27 publications

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“…Vinan-Vega et al compared the safety, appropriateness, and early results of surgical weight loss procedures in elderly patients and in younger controls (younger than 65 years of age). They presented evidence that bariatric surgery in patients 65 years old or older is safe and is not associated with increased surgical risk, with almost the same effects and nearly identical surgical complication rates as in younger patients, irrespective of the chosen bariatric procedure – laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass [7,30]. The previously mentioned meta-analysis by Giordano et al analyzed 7 studies involving 3128 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Weight loss subsequent to bariatric surgery causes sustainable improvement or remission of hypertension and type 2 diabetes mellitus in severely obese patients [4–6]. However, controversy exists with regard to the effectiveness and reasons for bariatric surgery in elderly patients [7–9]. In the recent past, weight loss through surgery was not recommended for elderly patients and was limited to patients under 60 years old based on age-dependent increased surgical risks [10].…”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

et al. 2019

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Background Controversy exists with regard to the effectiveness and reasons for bariatric procedures in patients older than 60 years. The goal of our study was to determine the reduction in risk of developing cardiovascular disease and type 2 diabetes mellitus after undergoing bariatric surgery in obese patients over age 60 at our institution. Material/Methods Patients with severe obesity (BMI >40 kg/m 2 ) were retrospectively included in the study. Risk of cardiovascular disease and type 2 diabetes at baseline and their reduction during the follow-up period were evaluated with the following selected, currently preferred risk algorithms: (1) the Systemic Coronary Risk Evaluation (SCORE) scale; (2) the Framingham Risk Score (of myocardial infarction or coronary death) for patients with no prior history of diabetes, coronary heart disease, or intermittent claudication; and (3) the Framingham Offspring Diabetes Risk Score, which estimates the 8-year risk of developing type 2 diabetes. Results All 33 elderly patients (32 women and 1 man, mean age 62.3±2.7 (BMI 44.3±6.2 kg/m 2 ) significantly reduced their risk levels. We observed a decrease in the 10-year risk of a first fatal cardiovascular event (3.5±0.5 vs. 2.4±0.5, absolute risk reduction [ARR] 1.0); reduced 10-year risk of myocardial infarction or death (5.0±1.6 vs. 3.25±1.6, ARR 1.7); and reduced predicted 8-year risk of developing type 2 diabetes (7.4±7.2 vs. 3.1±0.3, ARR 4.3). No intra- or postoperative complications were observed. Conclusions Our study showed a significant reduction in risk of developing cardiovascular diseases and type 2 diabetes, as measured by available risk scores, in elderly patients undergoing bariatric procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

et al. 2019

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“…References of the studies reviewed in this section: [ 8 , 9 , 19 , 20 , 23 , 24 , 29 , 33 , 40 , 41 , 46 , 47 , 48 , 49 , 53 , 54 , 55 , 56 , 60 , 63 , 64 , 66 , 68 , 69 , 72 , 86 , 88 , 89 , 91 , 92 , 93 , 94 , 100 , 102 , 106 , 107 , 108 , 109 , 112 , 114 , 117 , 118 , 119 , 135 , 137 , 139 , 140 , 144 , 149 , 158 , 159 ].…”

Section: Discussionunclassified

Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

et al. 2020

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In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4–8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1–1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements should be used at higher doses than are currently recommended. The use of proton-pump inhibitors should be individualised, and vitamin B12 and iron should be supplemented in case of deficit. All patients, especially pregnant women, teenagers, and elderly patients require a multidisciplinary approach and specialised follow-up. These recommendations and suggestions regarding nutrition management when undergoing bariatric surgery and postoperative follow-up have direct clinical applicability.

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“…La mayoría de las intervenciones quirúrgicas fueron bypass gástrico, al igual que en varios estudios 38 .…”

Section: Discussionunclassified

Primer reporte ecuatoriano de cirugía bariátrica en ancianos

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et al. 2020

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Introducción: la cirugía bariátrica es el tratamiento más eficaz para la obesidad, con beneficios metabólicos adicionales a la pérdida de peso. La evaluación preoperatoria adecuada y planificación quirúrgica son esenciales para su éxito, especialmente en pacientes de edad avanzada. Objetivo: determinar variación de peso, beneficios metabólicos y seguridad de cirugía bariátrica en ancianos, con seguimiento de dos años. Metodología: se incluyeron adultos ≥65 años sometidos a cirugía bariátrica laparoscópica en un hospital terciario privado de referencia en Ecuador, entre 2010 y 2019. Se midió pérdida de peso, mejoría de comorbilidades endocrino-metabólicas y complicaciones. Resultados: se incluyeron 16 pacientes; edad media: 68.5 años (DE: ± 4.2); 12 (75%) mujeres; 56.25% se sometió a bypass gástrico; 37.5% a gastrectomía en manga y 6.25% a un procedimiento revisional. En dos años, 13 pacientes mostraron un porcentaje de pérdida de peso total (%TWL) de 31.5% (DE: ± 3.0%) y un porcentaje de pérdida de exceso de peso (% EWL) de 72.9% (DE: ± 11.0) con bypass gástrico; y de 22.7% (DE: ± 3.2%) y 65.6% (DE: ± 13.0) con gastrectomía en manga, respectivamente. Diabetes mellitus tipo 2 remitió en 80%, hipertensión en 62.5% y dislipidemia en 60%. El 50% de complicaciones postoperatorias fueron Grado I según la clasificación Clavien Dindo. Conclusión: este es el primer reporte ecuatoriano sobre cirugía bariátrica en adultos mayores, demostrando su seguridad con baja tasa de complicaciones, su efectividad como tratamiento a corto plazo para la obesidad y sus comorbilidades, y beneficios similares a los presentados en sujetos más jóvenes.

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Bariatric Surgery in the Elderly Patient: Safety and Short-time Outcome. A Case Match Analysis

Cited by 30 publications

References 27 publications

A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

A Retrospective Study of 6-Month Reduction in Risk of Developing Cardiovascular Diseases and Type 2 Diabetes Mellitus in Severely Obese Patients Over 60 Years of Age Following Bariatric Surgery

Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

Primer reporte ecuatoriano de cirugía bariátrica en ancianos

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