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肥胖对腹腔镜子宫切除术技术的安全性有何影响?

What's the impact of the obesity on the safety of laparoscopic hysterectomy techniques?

作者信息

Kondo William, Bourdel Nicolas, Marengo Francesca, Botchorishvili Revaz, Pouly Jean Luc, Jardon Kris, Rabischong Benoit, Mage Gérard, Canis Michel

机构信息

Department of Gynecologic Surgery, University Hospital Center Estaing, Clermont-Ferrand, France.

出版信息

J Laparoendosc Adv Surg Tech A. 2012 Dec;22(10):949-53. doi: 10.1089/lap.2012.0213. Epub 2012 Oct 15.

Abstract

OBJECTIVE

To evaluate the impact of obesity in the safety of laparoscopic hysterectomy.

STUDY DESIGN

A retrospective study was conducted using a database of 2271 women undergoing laparoscopic hysterectomy for benign diseases between January 1995 and December 2008 at the Centre Hospitalier Universitaire Estaing (Clermont-Ferrand, France). Patients were divided into two groups according to the body mass index: <30 kg/m(2) (n=2088) and ≥ 30 kg/m(2) (n=183). Primary outcomes were differences in conversion rates, operating time, estimated blood loss, intraoperative complications, and early postoperative complications.

RESULTS

There was no difference in the operative time (121.3 versus 122.5 minutes; P=.71), in the difference between pre- and postoperative hemoglobin levels (1.8 versus 1.6 g/dL; P=.28), and in the conversion rate (4.6% versus 5.5%; P=.62) comparing the two groups. The overall intraoperative complication rate was 14.03% (n=293) and 13.66% (n=25) for nonobese and obese patients (P=.89), respectively. The overall postoperative complication rate was 8.81% (n=184) and 7.65% (n=14), respectively.

CONCLUSIONS

Obesity does not have an adverse effect on the feasibility and safety of laparoscopic hysterectomy in experienced hands.

摘要

目的

评估肥胖对腹腔镜子宫切除术安全性的影响。

研究设计

采用法国克莱蒙费朗市埃斯塔昂大学医院1995年1月至2008年12月期间2271例因良性疾病接受腹腔镜子宫切除术的女性患者数据库进行回顾性研究。根据体重指数将患者分为两组:<30 kg/m²(n = 2088)和≥30 kg/m²(n = 183)。主要结局指标为中转率、手术时间、估计失血量、术中并发症及术后早期并发症的差异。

结果

两组在手术时间(121.3对122.5分钟;P = 0.71)、术前和术后血红蛋白水平差异(1.8对1.6 g/dL;P = 0.28)以及中转率(4.6%对5.5%;P = 0.62)方面均无差异。非肥胖和肥胖患者的总体术中并发症发生率分别为14.03%(n = 293)和13.66%(n = 25)(P = 0.89)。总体术后并发症发生率分别为8.81%(n = 184)和7.65%(n = 14)。

结论

在经验丰富的医生手中,肥胖对腹腔镜子宫切除术的可行性和安全性没有不利影响。

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