Chen Chi Chiung Grace, Collins Sarah A, Rodgers Allison K, Paraiso Marie Fidela R, Walters Mark D, Barber Matthew D
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Gynecology and Obstetrics, Cleveland Clinic, Cleveland, OH, USA.
Am J Obstet Gynecol. 2007 Jul;197(1):98.e1-8. doi: 10.1016/j.ajog.2007.03.055.
The purpose of this study was to compare the incidence of perioperative complications in obese and normal-weight patients who undergo vaginal urogynecologic surgery.
A retrospective cohort analysis was conducted for obese patients (body mass index, > or = 30 kg/m2) who underwent vaginal surgery and who were matched with patients with normal body mass indices (> 18.5 kg/m2 but < 30 kg/m2) by surgical procedures. Demographic information, comorbidities, and perioperative (< or = 6 weeks) complications were documented. Logistic regression analysis was used to compare the incidence of perioperative complications and to adjust for baseline differences.
Seven hundred forty-two patients underwent vaginal surgery during the study period; 235 women were considered to have obese body mass indices. We matched 194 of these patients with normal-weight control subjects. There was no statistical difference in the proportion of subjects who had at least 1 perioperative complication (20% [obese] vs 15% [nonobese]). However, obese subjects were more likely to have an operative site infection (adjusted odds ratio, 5.5; [95% CI, 1.7-24.7]; P = .01).
The overall perioperative complication rate in obese and nonobese women is low, with obesity as an independent risk factor for the development of operative site infections.
本研究旨在比较接受阴道泌尿妇科手术的肥胖患者和正常体重患者围手术期并发症的发生率。
对接受阴道手术的肥胖患者（体重指数≥30kg/m²）进行回顾性队列分析，并根据手术程序将其与体重指数正常（>18.5kg/m²但<30kg/m²）的患者进行匹配。记录人口统计学信息、合并症和围手术期（≤6周）并发症。采用逻辑回归分析比较围手术期并发症的发生率，并对基线差异进行调整。
在研究期间，742例患者接受了阴道手术；235名女性被认为体重指数肥胖。我们将其中194例患者与正常体重的对照者进行匹配。至少有1种围手术期并发症的受试者比例无统计学差异（20%[肥胖]对15%[非肥胖]）。然而，肥胖受试者更有可能发生手术部位感染（调整后的优势比为5.5；[95%CI，1.7 - 24.7]；P = 0.01）。
肥胖和非肥胖女性围手术期总体并发症发生率较低，肥胖是手术部位感染发生的独立危险因素。
