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Abstract

Introduction: Role of bariatric surgery in elderly patients remains controversial. As the number of morbidly obese elderly population is on the rise, we need standardized management strategies and evaluation of outcomes of surgical management in this population. Here, we present our experience in treatment of morbidly obese Indian population. Methods: Retrospective analyses of bariatric procedures done at our centre on patients aged 60 years and above from January 2009 through December 2012 were done. The percentage of excess weight loss, resolution of comorbidities and quality of life were analyzed. Results: A total of 50 patients aged >60 years who underwent bariatric surgery were selected. 29 patients underwent LSG, 19 patients underwent RYGB & 2 patients underwent mini gastric bypass. The mean age of the patient was 63.38 years (range 60- 73). The mean preoperative weight was 108.25 kg (range 69.10 ? 167) and preoperative body mass index was 43.04 kg/m 2 (range 30.71-75.22). The percentage of excess weight loss at 6 months, 1, 2 and 3 years were 42.1%, 76%, 82% and 86% respectively. At 6, 12, 24 and 36 months follow-up, 58.5% (n = 50), 95.1% (n = 37), 100% (n = 27) and 100% (n = 10) of patients achieved at least 50% EWL respectively. Resolution of diabetes mellitus occurred in 95% of patients, while the remaining 5% were on reduced dose of oral medications only irrespective of whether they are on insulin or OHAs preoperatively. Discontinuation of medications for hypertension was noted in 86% of patients and remaining patients were on reduced dose of anti-hypertensives. In the quality of life survey, 90.3% of patients reported very good or good quality of life after surgery. Mean duration of hospital stay was higher than our patients in younger age group (3.19 days) with a range between 2 to 5 days. There was no mortality in our patients. Conclusion: In our experience, bariatric procedures can safely be done in elderly populations with resolution of co-morbidities and improved quality of life in majority of them.

Biography

Mahendra Narwaria obtained his master?s in Surgery from BJ Medical College, Gujarat University, Ahmedabad in 1996. Subsequently, he pursued his interest in Surgical Gastroenterology at (SGPGI), Lucknow. His perpetual drive for excellence and up-gradation of skills, prompted him to take up 'Bariatric Surgery' and till date has performed more than 2000 bariatric procedures. He is the chairman of Asian Bariatrics Pvt. Ltd, Ahmedabad, India. He is guest editor to Journal of Video-Surgery (Poland) and was past president of Obesity & Metabolic Surgery Society of India (OSSI). He also served as founder treasurer & secretary of OSSI and founder president of Association of Ahmedabad Surgeons (AAS). He has performed more than 100 live demonstrations for surgeons during different conferences in India and abroad and organized more than 20 national and international conferences. He is a visiting consultant at Apollo International Hospital Ahmedabad, Artemis Hospital, Gurgaon and Seven Hills Hospital, Mumbai. He is a teaching faculty at Ethicon Institute of Endosurgery, India and Center of Excellence in Minimal Access Surgery Training (CEMAST), Mumbai, India.