Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass.

BACKGROUND Advanced age is considered a relative contraindication to primary bariatric surgery at some institutions. As life expectancy is steadily increasing and quality of life is improving in our elderly population, we may need to reconsider the health benefits that obese elderly patients can obtain from bariatric surgery. Therefore, we examine the operative outcomes, weight loss, reduction of comorbidities, and medication requirements in patients older than 60 years compared with those younger than 60 years undergoing laparoscopic Roux-en-Y gastric bypass. HYPOTHESIS The null hypothesis tested in this study is that patients older than 60 years who undergo laparoscopic Roux-en-Y gastric bypass experience a medical benefit not significantly different from that experienced by younger patients in terms of the number of medications and comorbid conditions. METHODS The number of preoperative and postoperative comorbid conditions and the medications required for those conditions were compared between consecutive patients older than 60 years and those younger than 60 years who underwent Roux-en-Y laparoscopic gastric bypass. Early operative outcomes were also assessed. RESULTS Analysis of 110 patients younger than 60 years compared with 20 patients older than 60 years revealed no difference in complication rate or length of hospital stay. Younger patients lost more weight and had a significantly greater reduction in body mass index. Younger patients also demonstrated more complete resolution of comorbid conditions, although this difference was not significant. Older patients, who had more comorbid conditions requiring more medication at the time of surgery, experienced a greater medication reduction during follow-up, although this was not statistically significant. CONCLUSIONS Patients of advanced age can safely undergo laparoscopic Roux-en-Y gastric bypass. Younger patients can be expected to demonstrate greater weight loss and experience more complete resolution of their comorbid conditions. Older patients demonstrated greater overall reduction in medication requirements. Therefore, patients older than 60 years can be considered good candidates for obesity surgery and can be expected to enjoy substantial health benefits similar to those experienced by younger patients.