Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass in the Elderly: 1-Year Preliminary Outcomes in a Randomized Trial (BASE Trial)

• Published in: Obesity surgery Vol. 31; no. 6; pp. 2359 - 2363
• Main Authors: Pajecki, Denis, Dantas, Anna Carolina Batista, Tustumi, Francisco, Kanaji, Ana Lumi, de Cleva, Roberto, Santo, Marco Aurelio
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2021; Springer Nature B.V
• Subjects: Aged; Gastrectomy; Gastric Bypass; Gastrointestinal surgery; Humans; Laparoscopy; Medicine; Medicine & Public Health; Obesity, Morbid - surgery; Original Contributions; Surgery; Treatment Outcome; Weight Loss; Elderly patient; Bariatric surgery; Gastric bypass; Sleeve gastrectomy
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-021-05316-x

Purpose Despite the increasing prevalence of elderly obese patients, bariatric surgery remains controversial in this population. Recent publications have focused on perioperative safety, but few studies have addressed clinical outcomes. Objectives This study aimed to evaluate 1-year outcomes of laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients 65 years or older. Methods Thirty-six elderly obese patients were recruited for an open-label randomized trial from September 2017 to May 2019, comparing LSG to LRYGB. One-year outcomes were evaluated based on weight loss, functionality, and control of clinical conditions. Results The median age (67 × 67 years; p =0.67) and initial body mass index (BMI) (46.3 × 51.3 kg/m 2 ; p =0.28) were similar between groups. Preoperative BMI (after weight loss pre-operative treatment) was higher in LRYGB group (41.9 × 47.6 kg/m 2 ; p = 0.03). After 12 months, EWL and TWL were higher in LRYGB group (60 × 68%; p =0.04; 24.9 × 31.4%; p <0.01). HbA1c reduction was higher after LRYGB (−1.1 × −0.5%; p <0.01) as well as LDL control (−27.5 × +11.5 mg/dL p = 0.02). No difference was noted between LRYGB and LSG concerning hypertension control, triglycerides, HDL, and functionality. Conclusion Weight loss, diabetes, and LDL control were better achieved with LRYGB after 12 months. Graphical abstract