LOS ANGELES — Both seniors and adolescents can be good candidates for Roux-en-Y gastric bypass surgery, according to new research presented at the annual Digestive Disease Week.
In a review of 167 surgical cases at the Mayo Clinic in Rochester, Minn., involving patients aged 60 or older and adolescents aged 12–18 years, researchers found a significant decrease in obesity-related mortality after gastric bypass surgery, and limited morbidity and mortality overall.
The researchers reviewed the Mayo Clinic's 20-year bariatric surgery database and obtained morbidity and mortality rates from medical records. They also sent a questionnaire to surviving patients.
The older patients had higher rates of adverse events and saw less dramatic results both in decreases in body mass index (BMI) and self-reported declines in obesity-related health conditions. The 155 older patients—aged 60–76 years—had a 6% mortality after 5 years of follow-up, and 14% had had serious morbidities that delayed hospital discharge such as wound infections and bowel obstructions.
Patients reported about a 50% reversal in obesity-related comorbidities, and the mean BMI fell from 46 to 33 kg/m
Mortality for older patients (0.7%) was significantly lower than that in a previous report about Medicare patients, Dr. Sarr said. That study reported a 30-day mortality of nearly 5% in patients aged 65 and older (JAMA 2005;294:1903–8). “That is not our experience at the Mayo Clinic,” he said. But he added that mortality and morbidity post surgery can be high at centers that perform a low volume of these operations, while high-volume centers carry a much lower risk.
Among 12 adolescents aged 12–18 years, there were no serious adverse events and no deaths after 3 years of follow-up. The overall morbidity was about 10%, Dr. Sarr said. The adolescent patients had an average drop in BMI of 55 to 36, and patients reported experiencing an 82% reduction in obesity-related diseases.