Bariatric surgery in the elderly: A narrative review. 2017

Everton Cazzo, and Martinho Antonio Gestic, and Murillo Pimentel Utrini, and Felipe David Mendonça Chaim, and Francisco Callejas-Neto, and José Carlos Pareja, and Elinton Adami Chaim
Department of Surgery, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

BACKGROUND Due to population ageing, the elderly obese population is increasing. Bariatric surgery is the standard treatment option for morbid obesity nowadays, but there is some controversy regarding its routine indication in the elderly population. Objetive: To review the current evidence about bariatric surgery in the elderly. METHODS On-line search in the electronic databases Medline and Lilacs and compilation of the most significant data. The most relevant studies in the area over the past 16 years have been considered for this review. RESULTS There was significant methodological heterogeneity in the studies found in the literature. Historically, old age was associated with poorer outcomes after bariatric surgery, both in regards to early postoperative complications and less weight loss, and resolution of comorbidities. More recent studies have shown better results, with morbidity and mortality comparable to those observed in younger populations. More cautious patient selection and the evolution of the surgical technique appear to be the cause of such improvement. An extended multidisciplinary team including a geriatrician and a social worker may also help to improve the preoperative approach. CONCLUSIONS Bariatric surgery is a safe and effective therapeutic option in the elderly population, but careful patient selection and specific preoperative assessment are mandatory.

UI MeSH Term Description Entries
D009767 Obesity, Morbid The condition of weighing two, three, or more times the ideal weight, so called because it is associated with many serious and life-threatening disorders. In the BODY MASS INDEX, morbid obesity is defined as having a BMI greater than 40.0 kg/m2. Morbid Obesity,Obesity, Severe,Morbid Obesities,Obesities, Morbid,Obesities, Severe,Severe Obesities,Severe Obesity
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D050110 Bariatric Surgery Surgical procedures aimed at affecting metabolism and producing major WEIGHT REDUCTION in patients with MORBID OBESITY. Bariatric Surgeries,Bariatric Surgical Procedures,Metabolic Surgery,Stomach Stapling,Bariatric Surgical Procedure,Metabolic Surgeries,Procedure, Bariatric Surgical,Procedures, Bariatric Surgical,Stapling, Stomach,Surgeries, Bariatric,Surgeries, Metabolic,Surgery, Bariatric,Surgery, Metabolic,Surgical Procedure, Bariatric,Surgical Procedures, Bariatric

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