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腹壁成形术患者的腹腔镜袖状胃切除术:一项病例对照研究。

Laparoscopic sleeve gastrectomy in patients with abdominoplasty: a case-control study.

作者信息

Saber Alan A, Shoar Saeed, El-Matbouly Moamena, Karem Mohsen, Bashah Moataz M, Al Najjar Ahmad, Alkuwari Mohammad J, Soltanian Hooman

机构信息

Bariatric and Metabolic Institute, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York.

Bariatric and Metabolic Institute, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York.

出版信息

Surg Obes Relat Dis. 2017 Feb;13(2):144-149. doi: 10.1016/j.soard.2016.08.489. Epub 2016 Aug 26.

Abstract

BACKGROUND

Abdominoplasty is increasingly performed after weight loss surgery. However, performing a laparoscopic sleeve gastrectomy (LSG) after abdominoplasty poses technical challenges.

OBJECTIVE

The present study aimed to compare operative events and postoperative outcomes between LSG patients with and without a history of prior abdominoplasty.

SETTING

University hospital, Qatar.

METHODS

A case-control study was conducted on 2 groups of patients with (n = 33) and without (n = 69) prior abdominoplasty who underwent LSG. Patient demographics, baseline characteristics, as well as operative and postoperative events were compared between the 2 groups.

RESULTS

A total of 102 patients with an average age of 39.6±7.7 years and body mass index (BMI) of 42.8±5.9 kg/m were included. There were no significant differences between the 2 groups in terms of demographic characteristics, preoperative BMI, and co-morbidities. The number of ports required was significantly higher in the LSG patients with a history of prior abdominoplasty than in the nonabdominoplasty patients. The operation time was also significantly longer in the abdominoplasty patients than in the nonabdominoplasty patients (90.3±36.7 minutes versus 57.1±17.7 minutes; P<.0001). However, no significant differences were observed in terms of postoperative complications, length of hospital stay, and weight loss results.

CONCLUSION

LSG after abdominoplasty is associated with longer operative times and the need for additional port placement to overcome the decreased working space. However, operative strategies should be considered to overcome the technical challenges during LSG in patients who underwent a prior abdominoplasty.

摘要

背景

腹部整形术在减肥手术后越来越多地被实施。然而,在腹部整形术后进行腹腔镜袖状胃切除术(LSG)存在技术挑战。

目的

本研究旨在比较有和没有腹部整形术史的LSG患者的手术情况和术后结果。

地点

卡塔尔大学医院。

方法

对两组接受LSG的患者进行病例对照研究,一组有腹部整形术史(n = 33),另一组无腹部整形术史(n = 69)。比较两组患者的人口统计学特征、基线特征以及手术和术后情况。

结果

共纳入102例患者,平均年龄39.6±7.7岁,体重指数(BMI)为42.8±5.9kg/m²。两组在人口统计学特征、术前BMI和合并症方面无显著差异。有腹部整形术史的LSG患者所需的端口数量显著高于无腹部整形术史的患者。腹部整形术患者的手术时间也显著长于无腹部整形术史的患者(90.3±36.7分钟对57.1±17.7分钟;P<0.0001)。然而,在术后并发症、住院时间和体重减轻结果方面未观察到显著差异。

结论

腹部整形术后进行LSG与手术时间延长以及需要额外放置端口以克服工作空间减小有关。然而,对于曾接受腹部整形术的患者,应考虑手术策略以克服LSG期间的技术挑战。

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