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性别对Roux-en-Y胃旁路术后并发症发生率及预后的影响:来自德国肥胖症手术登记处的10000多例手术数据分析

Influences of gender on complication rate and outcome after Roux-en-Y gastric bypass: data analysis of more than 10,000 operations from the German Bariatric Surgery Registry.

作者信息

Stroh Christine, Weiner R, Wolff S, Knoll C, Manger Th

机构信息

SRH Municipal Hospital, Gera, Germany,

出版信息

Obes Surg. 2014 Oct;24(10):1625-33. doi: 10.1007/s11695-014-1252-8.

Abstract

BACKGROUND

Since 1 January 2005, bariatric surgery has been monitored in Germany. All related data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg.

METHODS

Data collection regarding obesity and metabolic surgery was started in an online database in 2005. Follow-up data are collected once a year. Participation in the quality assurance study is voluntary.

RESULTS

Since 2005, 10,330 Roux-en-Y gastric bypass (RYGB) procedures have been performed in Germany. In total, 8,013 patients were female and 2,317 were male. Male patients suffered significantly more comorbidities than female patients. The men also had higher body mass indexes (BMIs) and ages than the women at the time of operation. Data on the gender-specific aspects of RYGB from the Nationwide Survey of Bariatric Surgery in Germany (GBSR) showed a significant difference in anastomotic insufficiency at the gastro-entero-anastomosis. The leakage rate was 2.37 % (55/2,317) in men and 1.68 % (135/8,013) in women. Additionally, specific complication and mortality rates were significantly higher in male than in female patients.

CONCLUSIONS

Metabolic and obesity surgery is becoming increasingly popular in Germany. Data from the GBSR show significant differences in preoperative comorbidities and postoperative complication and mortality rates between male and female patients. There is a need for further evaluation of gender-specific aspects to optimize patient selection and reduce specific postoperative complications.

摘要

背景

自2005年1月1日起,德国开始对减肥手术进行监测。所有相关数据均与马格德堡奥托-冯-格里克大学外科质量保证研究所合作进行前瞻性登记。

方法

2005年开始在一个在线数据库中收集有关肥胖症和代谢手术的数据。每年收集一次随访数据。参与质量保证研究是自愿的。

结果

自2005年以来,德国共进行了10330例Roux-en-Y胃旁路术(RYGB)。其中,女性患者8013例,男性患者2317例。男性患者的合并症明显多于女性患者。男性患者在手术时的体重指数(BMI)和年龄也高于女性。德国全国减肥手术调查(GBSR)中关于RYGB性别特异性方面的数据显示,胃肠吻合口处的吻合口漏存在显著差异。男性的漏出率为2.37%(55/2317),女性为1.68%(135/8013)。此外,男性患者的特定并发症和死亡率明显高于女性患者。

结论

代谢和肥胖手术在德国越来越受欢迎。GBSR的数据显示,男性和女性患者术前合并症以及术后并发症和死亡率存在显著差异。需要进一步评估性别特异性方面,以优化患者选择并减少特定的术后并发症。

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