Gusenoff Jeffrey A, Messing Susan, O'Malley William, Langstein Howard N
Rochester, N.Y. From the Division of Plastic Surgery and the Department of Biostatistics and Computational Biology, University of Rochester.
Plast Reconstr Surg. 2008 Sep;122(3):951-958. doi: 10.1097/PRS.0b013e3181811c55.
More patients are undergoing plastic surgery after gastric bypass. Socioeconomic factors influencing the decision to have body contouring after gastric bypass have not been studied in the current literature.
In this study, 2501 consecutive gastric bypass patients were surveyed. Outcome variables were assessed by univariate and multivariable analyses.
Nine hundred twenty-six patients (817 women and 109 men) responded (40.3 percent of the 2296 surveys that at least may have been received), with a mean follow-up of 2.4 years. One hundred five (11.3 percent) underwent body contouring. Thirty-four patients assumed all costs for body contouring, and of these, 47 percent had multiple operations. Sixty-eight patients had some insurance coverage; 26 percent of these patients personally paid for additional body contouring. Having multiple procedures was not explained by any variables in our model. Body contouring was related to years since gastric bypass (p < 0.0001), post-gastric bypass body mass index (p < 0.03), change in body mass index (p < 0.0001), open versus laparoscopic gastric bypass (p < 0.0001), and income category greater than $20,000 (p < 0.03). Expenditures for body contouring were greater if the patient assumed costs versus had some insurance (p < 0.03), but were not related to income. Patients who assumed all costs of body contouring had lower pre-gastric bypass and post-gastric bypass body mass indexes (p < 0.007).
A minority of patients underwent body contouring. Patients assuming the costs of body contouring were twice as likely to have additional surgery. These results suggest that socioeconomic factors play an important role in the decision to have body contouring but may not predict who will have concomitant or additional procedures.
越来越多的患者在接受胃旁路手术后进行整形手术。目前的文献中尚未研究影响胃旁路手术后进行身体塑形决策的社会经济因素。
在本研究中，对2501例连续的胃旁路手术患者进行了调查。通过单变量和多变量分析评估结果变量。
926例患者（817名女性和109名男性）做出了回应（占至少可能收到的2296份调查问卷的40.3%），平均随访2.4年。105例（11.3%）接受了身体塑形。34例患者承担了身体塑形的所有费用，其中47%进行了多次手术。68例患者有部分保险覆盖；这些患者中有26%个人支付了额外的身体塑形费用。我们的模型中没有任何变量可以解释进行多次手术的原因。身体塑形与胃旁路手术后的年限（p < 0.0001）、胃旁路手术后的体重指数（p < 0.03）、体重指数的变化（p < 0.0001）、开腹与腹腔镜胃旁路手术（p < 0.0001）以及收入类别高于20,000美元（p < 0.03）有关。如果患者承担费用而非有部分保险，身体塑形的支出会更高（p < 0.03），但与收入无关。承担身体塑形所有费用的患者胃旁路手术前和手术后的体重指数较低（p < 0.007）。
少数患者接受了身体塑形。承担身体塑形费用的患者进行额外手术的可能性是其他患者的两倍。这些结果表明，社会经济因素在决定是否进行身体塑形方面起着重要作用，但可能无法预测谁会进行同期或额外的手术。
