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肥胖症患者减重术后身体塑形手术的并发症

Complications After Body Contouring Surgery in Postbariatric Patients.

作者信息

García Botero Alejandra, García Wenninger Miguel, Fernández Loaiza Dario

机构信息

From the *Department of Plastic Surgery, †Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia.

出版信息

Ann Plast Surg. 2017 Sep;79(3):293-297. doi: 10.1097/SAP.0000000000001109.

Abstract

INTRODUCTION

Over recent years, body contouring procedures in postbariatric patients have been in exponentially growing demand resulting in high complication rates rendering a variety of ciphers in the literature.

OBJECTIVE

The purpose of this study is to determine the complication rate in patients who have undergone body contouring surgery after bariatric surgery between June 2012 and March 2015 at Hospital de San José.

METHODS

A cohort study including 153 individuals who underwent a total of 198 body contouring procedures after massive weight loss following bariatric surgery was conducted. Data on variables, such as complication rate according to the type of body contouring surgery, major and minor complications, weight of resected tissue, or intraoperation time, among other variables, were analyzed.

RESULTS

A total of 198 procedures were performed in 153 patients. The mean (SD) age of the patients was 43.93 years (9.4 years). Of 198 procedures, 110 (55.5%) had complications. The rate for major complications was 13%, and for minor complications, 87%. Complication rates according to the type of operation were as follows: circumferential abdominal lipectomy, 55.7%; extended abdominal lipectomy, 53.7%; cruroplasty, 69%; breast surgery, 57%; and brachioplasty, 40%. Patients who presented with bleeding enough to require transfusion (P = 0.000) and with weight of the resected tissue greater than 2700 g in abdominoplasty (odds ratio, 3.26; 95% confidence interval, 1.48-7.1) had a higher complication rate. There were no thromboembolic events among this population.

CONCLUSIONS

The overall complication rate was 55.5%. The great majority were minor complications. The thromboprophylaxis regimen used was 100% effective.

摘要

引言

近年来,肥胖症患者术后身体塑形手术的需求呈指数级增长,导致并发症发生率很高,文献中出现了各种数据。

目的

本研究的目的是确定2012年6月至2015年3月在圣何塞医院接受减肥手术后进行身体塑形手术的患者的并发症发生率。

方法

进行了一项队列研究,纳入153例在减肥手术后体重大幅减轻后总共接受了198次身体塑形手术的个体。分析了各种变量的数据,如根据身体塑形手术类型的并发症发生率、主要和次要并发症、切除组织的重量或手术时间等其他变量。

结果

153例患者共进行了198次手术。患者的平均(标准差)年龄为43.93岁(9.4岁)。在198次手术中,110次(55.5%)出现并发症。主要并发症发生率为13%,次要并发症发生率为87%。根据手术类型的并发症发生率如下:环形腹部脂肪切除术,55.7%;扩大腹部脂肪切除术,53.7%;臀部整形术,69%;乳房手术,57%;上臂整形术,40%。出现足以需要输血的出血情况的患者(P = 0.000)以及腹部整形术中切除组织重量超过2700 g的患者(优势比,3.26;95%置信区间,1.48 - 7.1)并发症发生率更高。该人群中未发生血栓栓塞事件。

结论

总体并发症发生率为55.5%。绝大多数为轻微并发症。所采用的血栓预防方案100%有效。

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