Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Epilepsy Res. 2009 Dec;87(2-3):272-6. doi: 10.1016/j.eplepsyres.2009.09.017. Epub 2009 Oct 13.
The increasing prevalence of obesity is a significant health care concern. Individuals with obesity, i.e., a body mass index (BMI)>or=30, may have significant comorbid conditions that may increase the risk of general anesthesia and operative procedures. The rationale for the present investigation is to evaluate the importance of obesity on operative outcome in patients with intractable temporal lobe epilepsy undergoing surgical treatment.
This study involved a retrospective analysis of 244 adult patients who underwent epilepsy surgery at Mayo Clinic in Rochester, Minnesota between 1990 and 1996. The mean age of patients at surgery was 35 years (range, 18-68 years). There were 108 male patients (44%). Seventy-three patients (30%) were overweight (BMI 26-29), 56 patients (23%) were obese (BMI 30-39), and nine patients (4%) had extreme obesity (BMI>or=40) at the time of surgery.
The BMI was not predictive of the duration of intensive care unit or hospital stay following surgery, perioperative morbidity, or long-term seizure control following epilepsy surgery. Fifteen deaths occurred in the study period remote from the surgical procedure. The mortality during follow-up was increased for patients with extreme obese (p<0.007).
The perioperative morbidity and seizure outcome following epilepsy surgery was independent of the patient's body weight. However, long-term mortality was significantly increased in the individuals with extreme obesity. The effect of morbid obesity on long-term quality of life after epilepsy surgery may need to be considered in selecting operative candidates.
肥胖症的发病率不断上升是一个严重的医疗保健问题。肥胖患者（即 BMI≥30）可能患有严重的合并症，这可能会增加全身麻醉和手术的风险。本研究的目的是评估肥胖对接受手术治疗的难治性颞叶癫痫患者手术结果的重要性。
本研究回顾性分析了 1990 年至 1996 年间在明尼苏达州罗彻斯特市梅奥诊所接受癫痫手术的 244 例成年患者。患者手术时的平均年龄为 35 岁（范围为 18-68 岁）。有 108 名男性患者（44%）。73 名患者（30%）超重（BMI 26-29），56 名患者（23%）肥胖（BMI 30-39），9 名患者（4%）在手术时患有极度肥胖症（BMI≥40）。
BMI 不能预测术后重症监护病房或住院时间、围手术期发病率或癫痫手术后的长期癫痫控制情况。研究期间有 15 例死亡与手术过程无关。在随访期间，极度肥胖患者的死亡率增加（p<0.007）。
癫痫手术后的围手术期发病率和癫痫发作结果与患者的体重无关。然而，极度肥胖患者的长期死亡率显著增加。在选择手术候选者时，可能需要考虑病态肥胖对癫痫手术后长期生活质量的影响。
