Alameda, Los Angeles, and San Jose, Calif. From Alameda Hospital, the University of California, Los Angeles David Geffen School of Medicine, and the University of California, Berkeley.
Plast Reconstr Surg. 2013 Feb;131(2):238e-244e. doi: 10.1097/PRS.0b013e3182778649.
The question of whether or not abdominoplasty is associated with permanent weight reduction remains controversial. In coalition, should abdominoplasty be used as an adjunct for weight reduction in the overweight/obese patient?
This retrospective patient case series attempts to determine the most important factors associated with weight reduction.
All patients undergoing abdominoplasty had weight loss beyond that of their resected pannus, with a minimum body mass index reached 11.6 ± 1.7 weeks after surgery. Weight loss is attributed to an increase in satiety by 75 percent (n = 15) of patients. Preoperative body mass index greater than or equal to 24.5 kg/m can be used to predict long-term weight loss with a sensitivity and specificity of 92.9 percent and 83.3 percent, respectively. Patients above this threshold achieved significantly more weight loss (-4.5 ± 1.4 percent body mass index) at 1 year compared with their lower body mass index counterparts (p = 0.014), as did those with pannus resections weighing greater than 4.5 lb (p = 0.01).
Abdominoplasty performed on patients with a body mass index greater than 24.5 kg/m appears to be linked to sustained weight loss at 1 year. Satiety appears to be a prominent contributing factor, as does the amount of fat resected. Possible neurocrine mechanisms are discussed.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
腹部整形术是否与永久性体重减轻相关仍存在争议。在肥胖/超重患者中，腹部整形术是否应作为减肥的辅助手段？
本回顾性病例系列研究旨在确定与体重减轻相关的最重要因素。
所有接受腹部整形术的患者的体重减轻量均超过了切除的多余皮肤，且至少有 11.6±1.7 周达到了最低体重指数。体重减轻归因于 75%（n=15）的患者饱腹感增加。术前体重指数大于或等于 24.5kg/m²可用于预测长期体重减轻，其敏感性和特异性分别为 92.9%和 83.3%。超过此阈值的患者在 1 年内的体重减轻明显更多（体重指数减少 4.5±1.4%），与体重指数较低的患者相比（p=0.014），且多余皮肤切除量大于 4.5 磅的患者（p=0.01）也是如此。
对于体重指数大于 24.5kg/m²的患者进行腹部整形术似乎与 1 年内的持续体重减轻有关。饱腹感是一个重要的促成因素，切除的脂肪量也是如此。讨论了可能的神经激素机制。
临床问题/证据水平：治疗，IV。
