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腹腔镜Roux-en-Y胃旁路手术术前女性和男性的临床特征差异:83059例患者的分析

Variation in Clinical Characteristics of Women Men Preoperative for Laparoscopic Roux-en-Y Gastric Bypass: Analysis of 83,059 Patients.

作者信息

Schwartz Jandie, Bashian Christopher, Kushnir Leon, Nituica Cristina, Slotman Gus J

出版信息

Am Surg. 2017 Sep 1;83(9):947-951.

Abstract

Variation by sex in preoperative clinical characteristics of female and male laparoscopic Roux-en-Y gastric bypass (LRYGB) patients has not been evaluated comprehensively. The objective of our study was to identify clinical differences between morbidly obese women and men seeking LRYGB. Data from 83,059 patients in the Surgical Review Corporation's Bariatric Outcomes Longitudinal Database who were about to undergo LRYGB was analyzed in two groups: women (n = 65,325) and men (n = 17,734). Statistics were evaluated with analysis of variance and the χ2 equation. Cardiopulmonary comorbidities affected more men than women (P ≤ 0.0002) except for female asthma (P < 0.0001). Diabetes, gout, dyslipidemia, abdominal hernia, liver disease, alcohol and tobacco use, and substance abuse were higher for men (P < 0.0001). Women had gastroesophageal reflux disease, cholelithiasis, abdominal panniculitis, back pain, musculoskeletal pain, mental health disorders, depression, and impaired psychological status more often (P < 0.0001). Among LRYGB patients, men are older, smoke, and drink more, and have increased cardiopulmonary, metabolic, and liver disease versus women. Female somatic pain, gallstones, and mental health diagnoses are higher. This advance knowledge may aid management of LRYGB patients. By raising the index of suspicion for weight-related comorbidities, management of nonbariatric surgical patients may be facilitated.

摘要

女性和男性腹腔镜Roux-en-Y胃旁路术(LRYGB)患者术前临床特征的性别差异尚未得到全面评估。我们研究的目的是确定寻求LRYGB的病态肥胖女性和男性之间的临床差异。对手术回顾公司肥胖症纵向数据库中即将接受LRYGB的83059例患者的数据进行了两组分析:女性(n = 65325)和男性(n = 17734)。采用方差分析和χ2方程进行统计学评估。除女性哮喘外(P < 0.0001),心肺合并症对男性的影响大于女性(P ≤ 0.0002)。男性的糖尿病、痛风、血脂异常、腹疝、肝病、烟酒使用和药物滥用情况更高(P < 0.0001)。女性患胃食管反流病、胆结石、腹部脂膜炎、背痛、肌肉骨骼疼痛、心理健康障碍、抑郁症和心理状态受损的情况更常见(P < 0.0001)。在LRYGB患者中,男性年龄更大,吸烟和饮酒更多,与女性相比,心肺、代谢和肝脏疾病增加。女性的躯体疼痛、胆结石和心理健康诊断更高。这些预先了解的情况可能有助于LRYGB患者的管理。通过提高对与体重相关合并症的怀疑指数,可能有助于非肥胖手术患者的管理。

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