RESUMO
Background: As the population continues to age, the number of elderly patients affected by obesity is rising. Metabolic and bariatric surgery (MBS) can benefit elderly patients seeking treatment for obesity and its related diseases. We aimed to quantify percent excess weight loss (%EWL) for elderly patients (≥ 65) undergoing MBS at a single institution and compare our results to %EWL previously reported for general and elderly populations. Additionally, we believe the safety and effectiveness of MBS is repeatable in our community setting. Methods: Laparoscopic sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass performed from November 1, 2011 - April 30, 2017 at a single institution was retrospectively reviewed. Weight loss was measured at 3, 6, and 12 month follow-up. A total of 103 patients met inclusion criteria, mean age was 67.75 years old and mean pre-operative body mass index was 45.95 kg/m2. Results: Mean %EWL was 31.9%, 43.7%, and 53.4% at 3, 6, and 12 months, respectively. %EWL at one year was not statistically different to prior reports of elderly bariatric patients (p = 0.979). While statistically lower when compared to reports in the general population, %EWL in our elderly patients was clinically similar (p < 0.001). No 30-day mortality was observed. Conclusions: Elderly patients undergoing MBS were noted to have %EWL similar to previous reports in elderly and general populations. MBS is efficacious and well tolerated in the elderly population with repeatable results. Continued reporting on the safety and efficacy is important in ensuring wider coverage and availability of these important interventions in elderly populations.
Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Laparoscopia , Obesidade Mórbida , Cirurgiões , Humanos , Idoso , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Cirurgia Bariátrica/métodos , Derivação Gástrica/métodos , Redução de Peso , Obesidade , Laparoscopia/métodos , Gastrectomia/métodosRESUMO
Bowel obstruction is a known complication of Roux-en-Y gastric bypass. It can be caused by adhesions, internal hernia, incarcerated ventral hernia, or intussusception. Sometimes the underlying cause may be unusual. These 2 case reports describe patients who underwent laparoscopic Roux-en-Y gastric bypass and whose postoperative courses were complicated by small-bowel obstruction due to phytobezoars in the ileum, distal to the jejunojejunal anastomosis. We reviewed the literature by using PubMed and Medline for causes, pathogenesis, classifications, diagnosis, and management.
