Skip to main content
Top
Published in: Obesity Surgery 12/2016

01-12-2016 | Review Article

The Effectiveness and Safety of Sleeve Gastrectomy in the Obese Elderly Patients: a Systematic Review and Meta-Analysis

Authors: Yao Wang, Xiaoyan Yi, Qifu Li, Jun Zhang, Zhihong Wang

Published in: Obesity Surgery | Issue 12/2016

Login to get access

Abstract

Background

This systematic review was performed to compare the effectiveness and safety of SG in the obese elderly patients with the young ones.

Methods

Cohort studies that compared outcomes among old and young patients who had undergone SG were included. Summary odds ratios were estimated using a random effect model.

Results

Eleven studies were included. Old patients had a worse outcome in percentage of excess weight loss than the young ones (SMD −0.39, 95 % CI −0.55 to −0.24). No significant differences were recorded in resolution of co-morbidities: type 2 diabetes mellitus (OR 1.60, 95 % CI 0.843.05), hypertension (OR 1.05, 95 % CI 0.651.68), dyslipidemia (OR 1.38, 95 % CI 0.682.80), OSAS (OR 0.64, 95 % CI 0.301.34), or postoperative complications (OR 0.89, 95 % CI 0.511.55) between the elderly and the young who had undergone SG.

Conclusions

SG was effective for weight loss and resolution of co-morbidities with low complication rate in the obese elderly patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Solomon CG, Manson JE. Obesity and mortality: a review of the epidemiologic data. Am J Clin Nutr. 1997;66(4):1044–50. Solomon CG, Manson JE. Obesity and mortality: a review of the epidemiologic data. Am J Clin Nutr. 1997;66(4):1044–50.
2.
go back to reference Douketis JD, Macie C, Thabane L, et al. Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes. 2005;29(10):1153–67.CrossRef Douketis JD, Macie C, Thabane L, et al. Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes. 2005;29(10):1153–67.CrossRef
3.
go back to reference Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
4.
go back to reference Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral
5.
6.
go back to reference Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.CrossRefPubMed Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.CrossRefPubMed
7.
go back to reference D'Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed D'Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25(8):2498–504.CrossRefPubMed
8.
go back to reference Rosenthal RJ, Diaz AA, Arvidsson D, et al. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.CrossRefPubMed Rosenthal RJ, Diaz AA, Arvidsson D, et al. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.CrossRefPubMed
9.
go back to reference NIH conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991;115(12):956–61.CrossRef NIH conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991;115(12):956–61.CrossRef
10.
go back to reference Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Obes Surg. 2007;17(2):260–70.CrossRefPubMed Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Obes Surg. 2007;17(2):260–70.CrossRefPubMed
11.
go back to reference Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627–35.PubMedPubMedCentral Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627–35.PubMedPubMedCentral
12.
go back to reference Wool D, Bellatorre N, Wren S, et al. Male patients above age 60 have as good outcomes as male patients 50-59 years old at 1-year follow-up after bariatric surgery. Obes Surg. 2009;19(10):18–21.CrossRefPubMed Wool D, Bellatorre N, Wren S, et al. Male patients above age 60 have as good outcomes as male patients 50-59 years old at 1-year follow-up after bariatric surgery. Obes Surg. 2009;19(10):18–21.CrossRefPubMed
13.
go back to reference Musella M, Milone M, Maietta P, et al. Bariatric surgery in elderly patients. A comparison between gastric banding and sleeve gastrectomy with five years of follow up. Int J Surg. 2014;12(2):69–72.CrossRef Musella M, Milone M, Maietta P, et al. Bariatric surgery in elderly patients. A comparison between gastric banding and sleeve gastrectomy with five years of follow up. Int J Surg. 2014;12(2):69–72.CrossRef
14.
go back to reference Sosa JL, Pombo H, Pallavicini H, et al. Laparoscopic gastric bypass beyond age 60. Obes Surg. 2004;14(10):1398–401.CrossRefPubMed Sosa JL, Pombo H, Pallavicini H, et al. Laparoscopic gastric bypass beyond age 60. Obes Surg. 2004;14(10):1398–401.CrossRefPubMed
15.
go back to reference Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral
16.
go back to reference Abbas M, Cumella L, Zhang Y, et al. Outcomes of laparoscopic sleeve gastrectomy and roux-en-Y gastric bypass in patients older than 60. Obes Surg. 2015;25:2251–6.CrossRefPubMed Abbas M, Cumella L, Zhang Y, et al. Outcomes of laparoscopic sleeve gastrectomy and roux-en-Y gastric bypass in patients older than 60. Obes Surg. 2015;25:2251–6.CrossRefPubMed
17.
go back to reference Burchett MA, McKenna DT, Selzer DJ, et al. Laparoscopic sleeve gastrectomy is safe and effective in elderly patients: a comparative analysis. Obes Surg. 2015;25(12):222–8.CrossRefPubMed Burchett MA, McKenna DT, Selzer DJ, et al. Laparoscopic sleeve gastrectomy is safe and effective in elderly patients: a comparative analysis. Obes Surg. 2015;25(12):222–8.CrossRefPubMed
18.
go back to reference Gonzalez-Heredia R, Patel N, Sanchez-Johnsen L, et al. Does age influence bariatric surgery outcomes? Bariatr Surg Pract Patient Care. 2015;10(2):74–8.CrossRefPubMedPubMedCentral Gonzalez-Heredia R, Patel N, Sanchez-Johnsen L, et al. Does age influence bariatric surgery outcomes? Bariatr Surg Pract Patient Care. 2015;10(2):74–8.CrossRefPubMedPubMedCentral
19.
go back to reference Keren D, Matter I, Rainis T. Sleeve gastrectomy in different age groups: a comparative study of 5-year outcomes. Obes Surg. 2016;26(2):289–95.CrossRefPubMed Keren D, Matter I, Rainis T. Sleeve gastrectomy in different age groups: a comparative study of 5-year outcomes. Obes Surg. 2016;26(2):289–95.CrossRefPubMed
20.
go back to reference Leivonen M, Juuti K. A, Jaser N, et al. laparoscopic sleeve gastrectomy in patients over 59 years: early recovery and 12-month follow-up. Obes Surg. 2011;21(8):1180–7.CrossRefPubMed Leivonen M, Juuti K. A, Jaser N, et al. laparoscopic sleeve gastrectomy in patients over 59 years: early recovery and 12-month follow-up. Obes Surg. 2011;21(8):1180–7.CrossRefPubMed
21.
go back to reference Luppi CR, Balague C, Targarona EM, et al. Laparoscopic sleeve gastrectomy in patients over 60 years: impact of age on weight loss and co-morbidity improvement. Surg Obes Relat Dis. 2015;11(2):296–301.CrossRefPubMed Luppi CR, Balague C, Targarona EM, et al. Laparoscopic sleeve gastrectomy in patients over 60 years: impact of age on weight loss and co-morbidity improvement. Surg Obes Relat Dis. 2015;11(2):296–301.CrossRefPubMed
22.
go back to reference Mizrahi I, Alkurd A, Ghanem M, et al. Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years. Obes Surg. 2014;24(6):855–60.CrossRefPubMed Mizrahi I, Alkurd A, Ghanem M, et al. Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years. Obes Surg. 2014;24(6):855–60.CrossRefPubMed
23.
go back to reference Nagao Y, Diana M, Vix M, et al. Age impact on weight loss and glycolipid profile after laparoscopic sleeve gastrectomy: experience with 308 consecutive patients. Surg Endosc. 2014;28(3):803–10.CrossRefPubMed Nagao Y, Diana M, Vix M, et al. Age impact on weight loss and glycolipid profile after laparoscopic sleeve gastrectomy: experience with 308 consecutive patients. Surg Endosc. 2014;28(3):803–10.CrossRefPubMed
24.
go back to reference Pequignot A, Prevot F, Dhahri A, et al. Is sleeve gastrectomy still contraindicated for patients aged>/=60 years? A case-matched study with 24 months of follow-up. Surg Obes Relat Dis. 2015;11(5):1008–13.CrossRefPubMed Pequignot A, Prevot F, Dhahri A, et al. Is sleeve gastrectomy still contraindicated for patients aged>/=60 years? A case-matched study with 24 months of follow-up. Surg Obes Relat Dis. 2015;11(5):1008–13.CrossRefPubMed
25.
go back to reference Ritz P, Topart P, Benchetrit S, et al. Benefits and risks of bariatric surgery in patients aged more than 60 years. Surg Obes Relat Dis. 2014;14:4–5. Ritz P, Topart P, Benchetrit S, et al. Benefits and risks of bariatric surgery in patients aged more than 60 years. Surg Obes Relat Dis. 2014;14:4–5.
26.
go back to reference van Rutte PW, Smulders JF, de Zoete JP, et al. Sleeve gastrectomy in older obese patients. Surg Endosc. 2013;27(6):2014–9.CrossRefPubMed van Rutte PW, Smulders JF, de Zoete JP, et al. Sleeve gastrectomy in older obese patients. Surg Endosc. 2013;27(6):2014–9.CrossRefPubMed
27.
go back to reference Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study. J Gastrointest Surg. 2012;16(1):35–44.CrossRefPubMed Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study. J Gastrointest Surg. 2012;16(1):35–44.CrossRefPubMed
28.
go back to reference Sampath K, Dinani AM, Rothstein RI. Endoscopic devices for obesity. Curr Obes Rep. 2016;5(2):251–61.CrossRefPubMed Sampath K, Dinani AM, Rothstein RI. Endoscopic devices for obesity. Curr Obes Rep. 2016;5(2):251–61.CrossRefPubMed
29.
go back to reference van Hout GC, Verschure SK, van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15(4):552–60.CrossRefPubMed van Hout GC, Verschure SK, van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15(4):552–60.CrossRefPubMed
30.
go back to reference Fabricatore AN, Wadden TA, Moore RH, et al. Predictors of attrition and weight loss success: results from a randomized controlled trial. Behav Res Ther. 2009;47(8):685–91.CrossRefPubMedPubMedCentral Fabricatore AN, Wadden TA, Moore RH, et al. Predictors of attrition and weight loss success: results from a randomized controlled trial. Behav Res Ther. 2009;47(8):685–91.CrossRefPubMedPubMedCentral
31.
go back to reference Boza C, Daroch D, Barros D, et al. Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1129–33.CrossRefPubMed Boza C, Daroch D, Barros D, et al. Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1129–33.CrossRefPubMed
32.
go back to reference Vaidya V, Gangan N, Sheehan J. Impact of cardiovascular complications among patients with type 2 diabetes mellitus: a systematic review. Expert Rev Pharmacoecon Outcomes Res. 2015;15(3):487–97.CrossRefPubMed Vaidya V, Gangan N, Sheehan J. Impact of cardiovascular complications among patients with type 2 diabetes mellitus: a systematic review. Expert Rev Pharmacoecon Outcomes Res. 2015;15(3):487–97.CrossRefPubMed
33.
go back to reference Chenniappan M. Blood pressure variability: assessment, prognostic significance and management. J Assoc Physicians India. 2015;63(5):47–53.PubMed Chenniappan M. Blood pressure variability: assessment, prognostic significance and management. J Assoc Physicians India. 2015;63(5):47–53.PubMed
34.
go back to reference Bragg DA, Walling A. Metabolic syndrome: hyperlipidemia. FP Essent. 2015;435:17–23.PubMed Bragg DA, Walling A. Metabolic syndrome: hyperlipidemia. FP Essent. 2015;435:17–23.PubMed
35.
go back to reference Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736–47.CrossRefPubMed Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736–47.CrossRefPubMed
36.
go back to reference Oria HE, Moorehead MK. Updated bariatric analysis and reporting outcome system (BAROS. Surg Obes Relat Dis. 2009;5(1):60–6.CrossRefPubMed Oria HE, Moorehead MK. Updated bariatric analysis and reporting outcome system (BAROS. Surg Obes Relat Dis. 2009;5(1):60–6.CrossRefPubMed
37.
go back to reference Flum DR, Salem L, Elrod JA, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. Jam. 2005;294(15):1903–8.CrossRef Flum DR, Salem L, Elrod JA, et al. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. Jam. 2005;294(15):1903–8.CrossRef
38.
go back to reference Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82.CrossRefPubMedPubMedCentral Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82.CrossRefPubMedPubMedCentral
39.
go back to reference Turrentine FE, Wang H, Simpson VB, et al. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg. 2006;203(6):865–77.CrossRefPubMed Turrentine FE, Wang H, Simpson VB, et al. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg. 2006;203(6):865–77.CrossRefPubMed
Metadata
Title
The Effectiveness and Safety of Sleeve Gastrectomy in the Obese Elderly Patients: a Systematic Review and Meta-Analysis
Authors
Yao Wang
Xiaoyan Yi
Qifu Li
Jun Zhang
Zhihong Wang
Publication date
01-12-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2396-5

Other articles of this Issue 12/2016

Obesity Surgery 12/2016 Go to the issue

Letter to Editor/LED Reply

Malabsorption “Non Olet”