Espinosa-de-los-Monteros Antonio, de la Torre Jorge I, Rosenberg Laurence Z, Ahumada Leonik A, Stoff Alexander, Williams Eric H, Vásconez Luis O
Division of Plastic Surgery, University of Alabama at Birmingham and The Center for Advanced Surgical Aesthetics, 510 20th Street, South, 35294, USA.
Aesthetic Plast Surg. 2006 Jan-Feb;30(1):42-6. doi: 10.1007/s00266-005-0126-9.
Massive weight loss after bariatric surgery is associated with significant skin excess, laxity, and ptosis over the abdomen. Good results have been achieved with abdominoplasty and circumferential lipectomy. However, blood transfusions are sometimes needed, and patients may require long hospital stays. Furthermore, morbidity rates are high. Total abdominal liposuction performed with abdominoplasty allows for the preservation of lymphatic vessels below Scarpa's fascia and eliminates the need for upper flap undermining. This study aimed to evaluate this technique in patients with anterior abdominal redundancy attributable to massive weight loss after bariatric surgery.
The charts of 60 patients treated between December 2001 and October 2004 were retrospectively reviewed. All the patients had undergone previous bariatric surgery as well as subsequent total abdominal liposuction and abdominoplasty.
The average amount of wetting solution used was 3.1 l, and the average total aspirate was 2.5 l. The mean pannus weight was 3,649 g, and the average dimension was 48 x 25 x 6 cm. No patient required a blood transfusion. The median in-hospital stay was 1 day, with 42% of the patients treated as outpatients. The median follow-up period was 3 months. Morbidity was 22%. Factors associated with the development of complications were weight of the pannus, transverse dimension of the pannus, and body mass index. All the patients were satisfied with the results.
Total abdominal liposuction followed by abdominoplasty is adequate treatment for anterior abdominal redundancy for patients with massive weight loss.
减肥手术后的大量体重减轻与腹部明显的皮肤多余、松弛和下垂有关。腹壁成形术和环形脂肪切除术已取得良好效果。然而，有时需要输血，患者可能需要长时间住院。此外，发病率较高。在腹壁成形术中进行全腹抽脂可保留斯卡帕筋膜下方的淋巴管，无需进行上腹部皮瓣潜行分离。本研究旨在评估该技术在减肥手术后因大量体重减轻导致前腹壁冗余的患者中的应用效果。
回顾性分析2001年12月至2004年10月期间接受治疗的60例患者的病历。所有患者均接受过减肥手术以及随后的全腹抽脂和腹壁成形术。
平均使用的冲洗液量为3.1升，平均总吸出量为2.5升。平均赘肉重量为3649克，平均尺寸为48×25×6厘米。无患者需要输血。中位住院时间为1天，42%的患者作为门诊患者接受治疗。中位随访期为3个月。发病率为22%。与并发症发生相关的因素包括赘肉重量、赘肉横向尺寸和体重指数。所有患者对结果均满意。
对于因大量体重减轻导致前腹壁冗余的患者，先进行全腹抽脂再行腹壁成形术是一种合适的治疗方法。
