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60 岁以上患者行袖状胃切除术的早期发病率和死亡率趋势:德国减重手术登记处的回顾性研究和数据分析。

Trends in Early Morbidity and Mortality after Sleeve Gastrectomy in Patients over 60 Years : Retrospective Review and Data Analysis of the German Bariatric Surgery Registry.

机构信息

Department of General, Abdominal, and Pediatric Surgery, Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany.

University Hospital, Magdeburg, Germany.

出版信息

Obes Surg. 2018 Jul;28(7):1831-1837. doi: 10.1007/s11695-018-3110-6.

Abstract

BACKGROUND

The population are getting older and obesity is growing. Laparoscopic sleeve gastrectomy (LSG) is increasingly used worldwide but is still used with skepticism in the elderly. The purpose of our analysis is to judge the security of LSG in patients older than 60 years compared to patients younger than 60 years.

METHODS

This retrospective review included data of all patients in Germany who underwent LSG between January 2005 and December 2016.The data were published online in the German Bariatric Surgery Registry. A total of 21,571 operations were gathered and divided into two groups: group I, patients < 60 years old; and group II, patients ≥ 60 years old.

RESULTS

The total number of patients and the mean body mass index of group I and group II was 19,786, 51.7 ± 9.5 kg/m and 1771, 49.2 ± 8.1 kg/m, respectively. Regarding comorbidities, group II suffered statistically significantly more comorbidities than group I (p < 0.001). The general postoperative complications were 4.9% in group I and 7.8% in group II (p < 0.001). There was no significant difference in special postoperative complications (p = 0.048) and a slightly higher intraoperative complication rate in group II (2.2% vs. 1.6%, p = 0.048). Thirty-day mortality rate for group I versus II was 0.22% and 0.23% (p = 0.977), respectively.

CONCLUSIONS

LSG is a low-risk operation and safe surgical method with acceptable, not elevated perioperative morbidity and mortality rates in patients ≥ 60 years of age.

摘要

背景

人口老龄化和肥胖症的发病率不断增加。腹腔镜袖状胃切除术(LSG)在全球范围内的应用越来越广泛,但在老年人中仍存在一定的质疑。本分析的目的是评估 60 岁以上患者与 60 岁以下患者行 LSG 的安全性。

方法

本回顾性研究纳入了 2005 年 1 月至 2016 年 12 月期间在德国接受 LSG 的所有患者的数据。这些数据在德国减重手术注册中心在线发表。共收集了 21571 例手术,分为两组:I 组,年龄<60 岁;II 组,年龄≥60 岁。

结果

I 组和 II 组患者总数和平均 BMI 分别为 19786 例,51.7±9.5kg/m 和 1771 例,49.2±8.1kg/m。在合并症方面,II 组患者的合并症发生率显著高于 I 组(p<0.001)。I 组和 II 组的总体术后并发症发生率分别为 4.9%和 7.8%(p<0.001)。特殊术后并发症发生率无显著差异(p=0.048),但 II 组术中并发症发生率略高(2.2%比 1.6%,p=0.048)。I 组和 II 组的 30 天死亡率分别为 0.22%和 0.23%(p=0.977)。

结论

LSG 是一种低风险的手术,安全的治疗方法,对于 60 岁及以上患者具有可接受的、非升高的围手术期发病率和死亡率。

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