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大量减重后身体塑形手术的结果:一项前瞻性配对单盲研究。

Outcome in body-contouring surgery after massive weight loss: A prospective matched single-blind study.

作者信息

Tremp Mathias, Delko Tarik, Kraljević Marko, Zingg Urs, Rieger Ulrich M, Haug Martin, Kalbermatten Daniel F

机构信息

Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.

Department of General Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; Department of Surgery, Limmattal Hospital Zurich-Schlieren, Urdorferstrasse 100, 8952 Zurich, Switzerland.

出版信息

J Plast Reconstr Aesthet Surg. 2015 Oct;68(10):1410-6. doi: 10.1016/j.bjps.2015.05.035. Epub 2015 Jun 17.

Abstract

INTRODUCTION

Body-contouring (BC) procedures after massive weight loss (MWL) are extensive and numerous. Currently, inconsistent data exist regarding quality-of-life (QoL) scales, and long-term analysis is lacking. The aim of this study was to investigate the long-term outcome of patients who elect to have BC procedures after MWL.

METHODS

Post-bariatric patients and patients who had dietary weight loss with no history of bariatric surgery (BS) (BC group) were included. Patients after BS with similar demographic characteristics but no BC procedures served as the control group (BS group). The results were compared with severely obese patients who have not yet undergone BS or BC surgery (obese group). Outcome measures include the type of BC surgery with the rates of the associated procedures and outcome satisfaction evaluated after the Moorehead-Ardelt questionnaire (range -3.0 to +3.0).

RESULTS

Fifty-six female and 10 male Caucasian patients with a mean age of 50 years (14 years) who underwent BC procedures between February 1999 and October 2009 were included. Of those, 23 patients completed the survey in 2014 (20 female and three male patients, mean age of 53 years (14 years)) at a final follow-up of 8 years (3 years). Two years (range 1-3 years) after MWL, a total of 51 BC procedures were performed. The most frequent interventions were abdominoplasty (n = 20), followed by rectus plication and liposuction (n = 7 and n = 6, respectively). QoL scores revealed a high overall patient satisfaction in the BC group, which was comparable with the BS group (n = 23). The obese group (n = 17) had a significantly lower overall QoL and lower health-related QoL (HRQoL) subdomains compared with the BC and BS group.

CONCLUSION

BC procedures lead to high and durable patient satisfaction. However, the appropriate management of expectations before surgery is mandatory.

摘要

引言

大量减重(MWL)后的身体塑形(BC)手术范围广泛且数量众多。目前,关于生活质量(QoL)量表的数据并不一致,且缺乏长期分析。本研究的目的是调查选择在MWL后进行BC手术的患者的长期结果。

方法

纳入减重后患者以及通过饮食减重且无减重手术(BS)史的患者(BC组)。具有相似人口统计学特征但未进行BC手术的BS术后患者作为对照组(BS组)。将结果与尚未接受BS或BC手术的重度肥胖患者(肥胖组)进行比较。结果指标包括BC手术类型、相关手术的发生率以及根据穆尔黑德 - 阿德尔特问卷(范围为 -3.0至 +3.0)评估的结果满意度。

结果

纳入了1999年2月至2009年10月间接受BC手术的56名女性和10名男性白种患者,平均年龄为50岁(±14岁)。其中,23名患者在2014年完成了调查(20名女性和3名男性患者,平均年龄为53岁(±14岁)),最终随访时间为8年(±3年)。在MWL后两年(范围为1 - 3年),共进行了51例BC手术。最常见的干预措施是腹壁成形术(n = 20),其次是腹直肌折叠术和吸脂术(分别为n = 7和n = 6)。QoL评分显示BC组患者总体满意度较高,与BS组(n = 23)相当。与BC组和BS组相比,肥胖组(n = 17)的总体QoL和与健康相关的QoL(HRQoL)子领域显著较低。

结论

BC手术可带来较高且持久的患者满意度。然而,术前对期望进行适当管理是必不可少的。

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