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病态肥胖和皮肤切口选择对接受全腹子宫切除术患者手术结局的影响。

Effects of the morbid obesity and skin incision choices on surgical outcomes in patients undergoing total abdominal hysterectomy.

作者信息

Ersoy Ebru, Evliyaoğlu Özlem, Erol Okyar, Ersoy Ali Özgür, Akgül Mehmet Akif, Haberal Ali

机构信息

Etlik Zübeyde Hanım Women's and Children's Health Education and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.

Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.

出版信息

Turk J Obstet Gynecol. 2016 Dec;13(4):189-195. doi: 10.4274/tjod.67864. Epub 2016 Dec 15.

Abstract

OBJECTIVE

This study aimed to evaluate the effect of obesity on surgical outcomes in patients who underwent gynecologic surgery.

MATERIALS AND METHODS

In total, we evaluated 132 patients who underwent total abdominal hysterectomy with or without salpingo-oophorectomy for benign gynecologic procedures at our tertiary referral gynaecology clinic.

RESULTS

The non-morbid obese group [body mass index (BMI) <40 kg/m] included 94 patients, and the morbid obese group (BMI ≥40 kg/m) included 38 patients. The perioperative outcomes of the groups were compared. The mean operative time was significantly longer for morbid obese patients than non-morbid obese patients (p<0.05). Estimated blood loss, the need for blood transfusion, postoperative hemoglobin values, and the need for an intraabdominal drain were similar between the groups. Early and late postoperative complications were significantly more frequent in the morbid obese group than the other group (p<0.05, for each). Early postoperative complications in patients who underwent vertical skin incision were significantly more frequent than in patients who underwent pfannenstiel incision (p<0.05). Late complications were comparable between the two types of skin incision.

CONCLUSION

Morbid obesity significantly increases the mean operative times and the postoperative complication rates of abdominal hysterectomy operations.

摘要

目的

本研究旨在评估肥胖对接受妇科手术患者手术结局的影响。

材料与方法

我们总共评估了132例在我们的三级转诊妇科诊所接受全腹子宫切除术(无论是否同时行输卵管卵巢切除术)以治疗良性妇科疾病的患者。

结果

非病态肥胖组[体重指数(BMI)<40kg/m²]包括94例患者,病态肥胖组(BMI≥40kg/m²)包括38例患者。比较了两组的围手术期结局。病态肥胖患者的平均手术时间显著长于非病态肥胖患者(p<0.05)。两组之间的估计失血量、输血需求、术后血红蛋白值以及腹腔引流需求相似。病态肥胖组术后早期和晚期并发症的发生率均显著高于另一组(每组p<0.05)。接受垂直皮肤切口的患者术后早期并发症的发生率显著高于接受耻骨上横切口的患者(p<0.05)。两种皮肤切口的晚期并发症发生率相当。

结论

病态肥胖显著增加了腹式子宫切除术的平均手术时间和术后并发症发生率。

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