Abstract
BACKGROUND: Bariatric surgery is an effective treatment for obesity and its associated comorbidities. However, the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) for elderly and frail populations remain uncertain. OBJECTIVES: To validate the efficacy and safety of LSG for elderly and frail patients and to assess its impact on overweight and obesity-related comorbidities. METHODS: A retrospective cohort study of patients undergoing LSG at a university-affiliated single center between 2009 and 2022 from a prospectively maintained database. Patients were categorized into two cohorts based on age and frailty index: elderly vs younger patients and frail vs non-frail groups. Preoperative, perioperative, and postoperative data were analyzed. RESULTS: Frailty was associated with statistically significantly higher perioperative complications (%, Clavien-Dindo of III/IV, 8 vs 3) and lower treatment success rates (% Excess Body Weight Loss, six-month, year, and two-year, 58 vs 64, 73 vs 82, 72 vs 81, and 63 vs 76, respectively). Age was not shown to alter the safety or efficacy of the operation. CONCLUSION: While LSG is a viable option for elderly and frail patients, frailty is a significant predictor of treatment outcomes. A comprehensive assessment of individual factors, including frailty status, is essential for informed decision-making before surgery.