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[减重手术后皮肤切除术及腹壁成形术后的并发症与满意度]

[Complications and level of satisfaction after dermolipectomy and abdominoplasty post-bariatric surgery].

作者信息

García-García María Luisa, Martín-Lorenzo Juan Gervasio, Campillo-Soto Alvaro, Torralba-Martínez José Antonio, Lirón-Ruiz Ramón, Miguel-Perelló Joana, Mengual-Ballester Mónica, Aguayo-Albasini José Luis

机构信息

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Morales Meseguer, Murcia, España.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Morales Meseguer, Murcia, España.

出版信息

Cir Esp. 2014 Apr;92(4):254-60. doi: 10.1016/j.ciresp.2013.04.024. Epub 2013 Dec 18.

Abstract

BACKGROUND

Body contouring surgery is in high demand following the increase in bariatric surgery. But these types of procedures are associated with high complication rates that cause long hospital stays and have a negative effect on patient satisfaction. The purpose of this study is to identify predictors of complications in order to optimize outcomes in these patients and find a relationship between complication rate and satisfaction.

MATERIAL AND METHODS

Out of a group of 175 post-bariatric patients, 72 patients underwent body contouring surgery following massive weight loss from 2003-2008. They were reviewed retrospectively for demographic data, pre- and postoperative weight status, co-morbidities and complications and reoperation rate. Patient satisfaction was evaluated.

RESULTS

a)

COMPLICATIONS

The overall complication rate was 45.8%. The most frequent were seromas (23.6%); infection (13.9%), bleeding (11.1%), hematoma (6.9%) (needing transfusions [6.9%]), skin necrosis (6.9%) and umbilical necrosis (4.2%). A total of 8 patients required reoperation (11.1%). b) Satisfaction rating: 1) very satisfied: 51.4%, 2) satisfied: 31.9%, 3) dissatisfied: 8.3%, 4) very dissatisfied: 8.3%. c) The presence of complications was significantly associated with patients' satisfaction, reoperation rate and longer hospital stays (P<.001).

CONCLUSIONS

Post operative complications were frequent. No predictors could be found to prevent these complications and optimize patient selection and appropriate timing of surgery. Patients with complications had a significantly higher reoperation rate, longer hospital stay and more dissatisfaction. The patients' satisfaction was negatively influenced by complication occurrence and not by the aesthetic results.

摘要

背景

减肥手术后,身体塑形手术的需求大增。但这类手术并发症发生率高,导致住院时间延长,对患者满意度产生负面影响。本研究旨在确定并发症的预测因素,以优化这些患者的手术效果,并找出并发症发生率与满意度之间的关系。

材料与方法

在一组175例减肥后患者中,72例患者在2003年至2008年体重大幅减轻后接受了身体塑形手术。对他们的人口统计学数据、术前和术后体重状况、合并症、并发症及再次手术率进行回顾性分析。评估患者满意度。

结果

a) 并发症:总体并发症发生率为45.8%。最常见的是血清肿(23.6%);感染(13.9%)、出血(11.1%)、血肿(6.9%)(需要输血[6.9%])、皮肤坏死(6.9%)和脐坏死(4.2%)。共有8例患者需要再次手术(11.1%)。b) 满意度评分:1) 非常满意:51.4%,2) 满意:31.9%,3) 不满意:8.3%,4) 非常不满意:8.3%。c) 并发症的发生与患者的满意度、再次手术率及住院时间延长显著相关(P<0.001)。

结论

术后并发症很常见。未发现可预防这些并发症并优化患者选择及手术时机的预测因素。有并发症的患者再次手术率显著更高、住院时间更长且满意度更低。并发症的发生对患者满意度产生负面影响,而非美学效果。

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