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NESS 2006 Annual Meeting
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Bariatric Surgery is Safe and Effective in Patients Over 65:A Report from the Massachusetts Morbid Obesity Study Group
Joshua Felsher, Liam Haveran, Vera Freeman, Robin Mason, Don Czerniach, Rich Perugini, John Kelly
University of Massachusetts, Worcester, MA

Background: Recently published reports have questioned the safety and efficacy of bariatric surgery in the elderly. As the lifespan of the American population continues to increase, the potential health and quality of life benefits of bariatric surgery are marked. Based on data collected by the Massachusetts Morbid Obesity Study Group, patient age should not preclude bariatric surgery as an option for the elderly, morbidly obese. Surgery in this population is both safe and effective.
Methods: A retrospective review of prospectively acquired data regarding all bariatric operations performed at 4 academic centers in Massachusetts between January 1, 2000 and December 1, 2005 was performed.
Results: 55 patients were 65 or older at the time of surgery (range 65-77 years). 38 patients were female. Mean preoperative body mass index was 48.9 kg/m2 (range 36-67). Operations included Laparoscopic Roux-En-Y Gastric Bypass (LRYGBP) (n=21), Laparoscopic Adjustable Gastric Banding (LAGB) (n=16) and Open Roux-En-Y Gastric Bypass (RYGBP) (n=12). There were no mortalities in the first 30 days postoperatively and there was one mortality within the first year. Mean excess body weight loss one year postoperatively was 60.4% (range 43.3-75.8%), 60.0% (range 29.7-80.0%) and 32.7% (range 12.6-57.1%) following LRYGBP, RYGBP and LAGB respectively.
Conclusions: Patients aged 65 years and older can safely undergo bariatric surgery with minimal morbidity. Furthermore, this population can experience similar weight loss and resolution of co-morbidities to that seen in younger patients undergoing the same procedure. Failure to offer bariatric surgery on the basis of patient age is neither evidence-based nor ethical.

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