Coblijn U K, de Raaff C A L, Lagarde S M, de Castro S M M, Vrouenraets B C, van Wagensveld B A
Department of Surgery, Sint Lucas Andreas Ziekenhuis, Usha Coblijn, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Department of Surgery, Academisch Medisch Centrum, Amsterdam, Netherlands.
Obes Surg. 2016 Sep;26(9):2213-2220. doi: 10.1007/s11695-016-2094-3.
Around 10 % of the bariatric surgery patients experience postoperative complications (<30 days). It could be hypothesized that complications influence postoperative weight loss, which is one of the most important endpoints of bariatric surgery. Therefore, this study inventoried the effect of complications on postoperative weight loss.
A consecutive database including patients who were operated from November 2007 onwards was retrospectively reviewed. All short-term complications were classified according to the Clavien-Dindo classification. Weight loss was assessed at 6 and 12 months postoperatively.
A total of 1130 patients underwent either primary (n = 907, 80.3 %) or revisional (n = 233, 19.7 %) surgery till October 2013. Short-term complications occurred in 115 (10.2 %) patients, of whom 48 (41.7 %) had a severe (Clavien-Dindo ≥ 3) complication. One year post surgery, 184 patients (16.3 %) were lost to follow-up. Patients with a short-term complication had a higher percentage of excess weight loss (%EWL) at 6 months (58.6 (SD 16.6) versus 52.9 (SD 17.6), p = 0.003) and 1 year (71.9 (SD 22.3) versus 65.9 (SD 21.3), p = 0.017) of follow-up. Although a trend was seen toward higher BMI loss and total weight loss (TWL) after 6 months, no effect was seen 1 year postoperatively. In multivariable linear regression analysis, complications were not a significant predictor for 1-year %EWL.
Although short-term complications alter 1-year %EWL, no effect was seen on BMI loss and TWL. In addition, complications were not a predictor in a multivariable linear regression model for 1-year %EWL. It can be concluded that short-term complications do not impair weight loss after Roux-en-Y gastric bypass.
约10%的减肥手术患者会出现术后并发症（<30天）。可以推测，并发症会影响术后体重减轻，而这是减肥手术最重要的终点之一。因此，本研究详细列出了并发症对术后体重减轻的影响。
对一个连续数据库进行回顾性分析，该数据库包括2007年11月起接受手术的患者。所有短期并发症均根据Clavien-Dindo分类法进行分类。在术后6个月和12个月评估体重减轻情况。
截至2013年10月，共有1130例患者接受了初次手术（n = 907，80.3%）或翻修手术（n = 233，19.7%）。115例（10.2%）患者出现短期并发症，其中48例（41.7%）发生严重（Clavien-Dindo≥3级）并发症。术后1年，184例患者（16.3%）失访。有短期并发症的患者在随访6个月时超重减轻百分比（%EWL）更高（58.6（标准差16.6）对52.9（标准差17.6），p = 0.003），随访1年时也更高（71.9（标准差22.3）对65.9（标准差21.3），p = 0.017）。虽然术后6个月时BMI降低和总体重减轻（TWL）有升高趋势，但术后1年未见影响。在多变量线性回归分析中，并发症不是1年%EWL的显著预测因素。
虽然短期并发症会改变1年%EWL，但对BMI降低和TWL未见影响。此外，在多变量线性回归模型中，并发症不是1年%EWL的预测因素。可以得出结论，短期并发症不会损害Roux-en-Y胃旁路术后的体重减轻。
