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

Loy, John; Youn, Heekoung; Schwack, Bradley; Kurian, Marina; Fielding, George; Ren-Fielding, Christine

doi:10.1016/j.soard.2013.06.022

Cited by 23 publications

(7 citation statements)

References 19 publications

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“…For studies in which weight outcome was reported as percentage excess weight loss (%EWL), older persons undergoing RYGB or LSG lost 46% to 77% excess weight at 12 to 21 months, and 43% to 72% 2 to 6 years post‐operatively . After LAGB, studies reported %EWL of 14% to 36% at 1 year, and 35% to 48% at 5 years' follow‐up . Studies comparing types of surgery reported that RYGB was associated with greater or equal weight loss compared with sleeve gastrectomy, and both RYGB and sleeve gastrectomy were associated with more weight loss than LAGB .…”

Section: Resultsmentioning

confidence: 99%

Treatment of obesity in older persons—A systematic review

Haywood

Sumithran

2019

Obesity Reviews

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The study aims to systematically review the available evidence regarding weight loss interventions (lifestyle, surgical, and pharmacological) for obesity in adults aged over 60 years. A search of prospective, randomized studies took place in January 2018, on Medline (Web of Science) and PubMed databases. Search terms included the following: elderly, obese, hypocaloric, pharmacotherapy, and bariatric surgery. Abstracts were screened for eligibility. A total of 256 publications regarding lifestyle interventions were identified; of these, 69 studies were eligible. As no eligible studies were identified for pharmacotherapy or bariatric surgery, the search was broadened to include non-randomized studies. Four pharmacotherapy and 66 surgery studies were included. Lifestyle intervention had similar weight loss efficacy in older compared with younger people, with positive effects on a number of relevant outcomes, including physical function and cardiovascular parameters. There was little data regarding obesity pharmacotherapy in older persons. The available data for bariatric surgery indicate comparable weight loss and resolution of type 2 diabetes, with similar or slightly higher complication rates in older compared with younger people. Older age alone should not be considered a contraindication to intensive lifestyle or surgical intervention for obesity. There are insufficient data to guide clinical decisions regarding obesity pharmacotherapy in older people. Abstract] OR RCT [Title/Abstract] OR randomly [Title/Abstract] OR random [Title/Abstract]) #1 Search ((obesity [Title/Abstract] OR obese [Title/Abstract] OR "weight loss"[Title/Abstract] OR "weight reduction"[Title/ Abstract])) AND (elderly [Title/Abstract] OR older [Title/ Abstract] OR geriatric [Title/Abstract]) HAYWOOD AND SUMITHRAN 589

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Section: Resultsmentioning

confidence: 99%

Treatment of obesity in older persons—A systematic review

Haywood

Sumithran

2019

Obesity Reviews

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“…No primary studies met the full criteria for inclusion in this review. Ten manuscripts reporting on bariatric surgery studies were identified in which data were reported in older patients, although the studies were not specifically designed to report on the outcomes of bariatric interventions in 641 older patients with T2DM or other comorbidities (Table 1) [ [16][17][18][19][20]24]. Four registry studies were identified in which data were reported on older patients, which yielded little efficacy data but did yield postoperative mortality and 30-day complication rates in 6837 patients.…”

Section: Resultsmentioning

confidence: 99%

“…The prevalence of surgical operations was 478 patients receiving laparoscopic adjustable gastric banding (LAGB) [14][15][16][17][18][19]24], 52 laparoscopic sleeve gastrectomies (LSGs) [20,21], 36 Roux-en-Y gastric bypasses [15,23] and a mixed series of open and laparoscopic gastric bypass (LGBP) operations in 80 patients [22]. No consistent definition of improvement nor resolution of T2DM, hypertension or OSA was used in these studies.…”

Section: Outcomes Of Bariatric Surgerymentioning

confidence: 99%

Bariatric surgery in obese older people

Reijntjes¹,

Viljoen

Wierzbicki

et al. 2015

Cardiovascular Endocrinology

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Objective The aim of this study was to determine whether older (≥65 years) obese people would benefit from bariatric surgery, considering the prevalence of multiple comorbidities and frailty in this group.Methods A PubMed search was carried out for studies on the use of bariatric surgery in older obese people published in the database from 1980 to the present (August 2014).Results A total of 244 citations were obtained on searching; 182 of these publications were selected for manual checking and 10 studies were identified as containing useable data on this patient cohort. Published data were available for efficacy in 641 patients. Substantial improvement was observed in diabetes (76%), hypertension (68%) and sleep apnoea (67%) following bariatric surgery. Laparoscopic adjustable gastric banding (n = 456) was the most frequently reported procedure. Similar findings but with greater weight loss and fewer complications were found in the small numbers of patients undergoing other procedures. Data from four large registry studies (n = 6837) showed mortality and complications associated with bariatric surgery to be increased in older compared with younger people especially in those undergoing gastric bypass surgery. The elderly had longer hospital stays, and patients with cardiac, pulmonary or renal comorbidities generally had a worse prognosis.Conclusion Bariatric surgery in older people is effective in reducing complications of obesity, but is also associated with increased rates of complications compared with those seen in younger patients. The few reported studies in the elderly are retrospective, generally small, primarily describe findings of laparoscopic adjustable gastric banding as the surgical intervention option and lack long-term follow-up. More trials and registry data, especially for sleeve gastrectomy and gastric bypass, are required to better address the utility of bariatric surgery in the elderly and to define long-term clinical outcomes. Cardiovasc Endocrinol 4:60-66

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“…Some centers are reluctant to perform LRYGB on patients older than 65. As such, the availability of a less-invasive, outpatient surgical option such as LAGB is critical [6]. In experienced hands, LAGB has been well tolerated in patients over 70 years old, and has led to moderate resolution of comorbidities as well, with few complications [6].…”

Section: Introductionmentioning

confidence: 99%

“…As such, the availability of a less-invasive, outpatient surgical option such as LAGB is critical [6]. In experienced hands, LAGB has been well tolerated in patients over 70 years old, and has led to moderate resolution of comorbidities as well, with few complications [6]. Non-elderly older patients (age over 50) are an increasingly larger proportion of operative candidates, but there are few studies that specifically examine this demographic.…”

Section: Introductionmentioning

confidence: 99%

Impaired weight loss in laparoscopic adjustable gastric banding patients over 50 years of age: diabetes mellitus as an independent risk factor

et al. 2015

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Introduction Laparoscopic Adjustable Gastric Banding (LAGB) represents a safe and effective bariatric procedure, particularly for patients over 50. Preoperative risk factors for impaired post-LAGB excess weight loss are not well characterized for this population. This study aimed to identify demographics, characteristics or comorbidities associated with excess weight loss at 6 and 12 months postoperatively (EWL180 and EWL365, respectively) for these patients. Methods 117 LAGB patients > 50 years of age from 2005-2014 were retrospectively reviewed for factors potentially associated with EWL180 and EWL365. Rationally selected variables chosen for analysis included age, race, gender, initial body-mass index and preoperative weight loss; comorbidities assessed included hypertension, psychiatric disorders and diabetes mellitus (DM). Variables correlated with EWL180 or EWL365 on bivariate linear regression analysis (P ≤ .05) were input into multivariate linear regression analysis to confirm independent association. Results Preoperative DM (B = −9.1% EWL; 95% CI −13.6%, −4.5%; P < .001) and African-American race (B = −8.8% EWL; 95% CI −17.3%, −0.3%; P = .05) were independent risk factors for impaired EWL180. Only DM was a risk factor for impaired EWL365 (B = −9.7% EWL; 95% CI −17.7%, −1.8%; P = .02). Conclusions LAGB is a successful operation in patients > 50 years of age. Preoperative DM is an independent risk factor for impaired EWL in this cohort.

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

Cited by 23 publications

References 19 publications

Treatment of obesity in older persons—A systematic review

Treatment of obesity in older persons—A systematic review

Bariatric surgery in obese older people

Impaired weight loss in laparoscopic adjustable gastric banding patients over 50 years of age: diabetes mellitus as an independent risk factor

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