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Long-Term Results of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Individuals Older Than 60 Years with Morbid Obesity

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Abstract

Purpose

An increasing Pnumber of individuals with obesity over the age of 60 years require bariatric surgery to treat obesity and its related medical problems. Sleeve gastrectomy and Roux-en-Y gastric bypass have already proven their efficacy in this population, but literature lacks reports of long-term results. The aim of this study is to compare long-term results of sleeve gastrectomy and Roux-en-Y gastric bypass in individuals older than 60 years old.

Materials and Methods

This is a single-center, retrospective, comparative study of 204 patients undergoing either sleeve gastrectomy (123, 60.3%) or Roux-en-Y gastric bypass (81, 39.7%) for morbid obesity with a mean follow-up of 44.5 ± 19.1 months and 54.6 ± 17.9 months, respectively.

Results

Total weight loss was significantly increased for patients who underwent Roux-en-Y gastric bypass compared to sleeve gastrectomy from 12 to 48 months after surgery, while no significant difference was found after 60 (30.39% vs. 27.63%) and 72 (27.36% vs. 23.61%) months. Roux-en-Y gastric bypass was associated to a significant increased rate of early postoperative complications (22.2% vs. 4%; p < 0.0001), but no difference was found concerning late postoperative morbidity (6.2% vs. 1.6%). Both procedures were effective in obesity related medical problems.

Conclusion

Roux-en-Y gastric bypass confers an increased weight loss than sleeve gastrectomy in patients over the age of 60 in the mid-term, but it is associated with more early postoperative complications. Sleeve gastrectomy can be considered a valid alternative as long-term weight loss results are superposable to those ensured by Roux-en-Y gastric bypass.

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Author information

Authors and Affiliations

  1. Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Archet 2 Hospital, Nice, France

    Céline Drai, Andrea Chierici, Imed Ben Amor & Antonio Iannelli

  2. Université Côte d’Azur, Nice, France

    Céline Drai, Stéphane Schneider & Antonio Iannelli

  3. Unit of General and Emergency Surgery, University Hospital San Giovanni Di Dio E Ruggi d’Aragona, Mercato San Severino, Salerno, Italy

    Luigi Schiavo

  4. Department of Gastroenterology and Clinical Nutrition, CHU de Nice, University Côte d’Azur, Nice, France

    Stéphane Schneider

  5. Inserm, U1065, Team 8 “Hepatic Complications of Obesity and Alcohol”, Nice, France

    Antonio Iannelli

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  1. Céline Drai
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Correspondence to Antonio Iannelli.

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Key Points

• No significant total weight loss between SG and RYGB at 72 months (27.36% vs. 23.61%).

• Fewer early complications for SG over 60 (4% vs. 22.2%; p < 0.0001).

• Late complications: 6.2% (RYGB) vs 1.6% (SG), non-significative.

• No differences in obesity-related medical problems between SG and RYGB.

Appendix 1

Appendix 1

Questionnaires used for the purpose of follow-up

Questionnaire number 1: Regarding GERD

  1. 1.

    Do you experience heartburn (chest pain going to the neck)?

  2. 2.

    Are these effects enhanced by eating a meal or by lying down?

  3. 3.

    Do you have regurgitations or acid uplifting sensations?

  4. 4.

    Do you take long-term antacid therapy?

The clinical diagnosis of GERD was retained if the patient answer was “yes” to the first three questions.

Questionnaire number 2: Regarding eating habits

Patients are instructed by dedicated dietician before surgery, two times the first postoperative year and yearly thereafter.

  1. 1.

    Do you have increased the number or frequency of meals?

  2. 2.

    Do you wake up during the night to have food?

It was assumed that the patient had changed his or her heating habits if he or she answered yes to the first two questions.

Questionnaire number 3: Overall satisfaction with surgery

  1. 1.

    Are you satisfied with the surgery?

  2. 2.

    Has your quality of life improved even partially?

  3. 3.

    Were you satisfied with the postoperative follow-up?

Satisfaction was considered complete if the answer to the three previous questions was positive.

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Drai, C., Chierici, A., Schiavo, L. et al. Long-Term Results of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Individuals Older Than 60 Years with Morbid Obesity. OBES SURG 33, 3850–3859 (2023). https://doi.org/10.1007/s11695-023-06851-5

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