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肥胖症手术在高危患者中的可行性与安全性:单中心经验

Feasibility and Safety of Bariatric Surgery in High-Risk Patients: A Single-Center Experience.

作者信息

Moulla Yusef, Lyros Orestis, Blüher Matthias, Simon Philipp, Dietrich Arne

机构信息

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany.

Integrated Treatment and Research Centre (IFB) for Obesity Diseases, Philipp-Rosenthal-St. 27, 04103 Leipzig, Germany.

出版信息

J Obes. 2018 Jan 14;2018:7498258. doi: 10.1155/2018/7498258. eCollection 2018.

Abstract

INTRODUCTION

Despite the feasibility and safety of bariatric procedures nowadays, high-risk patients with vast obesity and severe comorbidities demonstrate relatively high perioperative morbidity and mortality rates and, therefore, form a distinguished challenge for the bariatric surgeons.

METHODS

We retrospectively analyzed high-risk patients, who underwent bariatric surgery in University Hospital Leipzig between May 2012 and December 2016. High-risk patients were defined when (Bergeat et al., 2016) at least one of the following risk factors was met: age ≥ 70 years, body mass index (BMI) > 70 kg/m, liver cirrhosis, end-organ failure, or immunosuppression by status after organ transplantation along with (Birkmeyer et al., 2010) at least two comorbidities associated with obesity. Our analysis included early postoperative complications.

RESULTS

A total of 25 high-risk obese patients were identified. All patients had a standardized postoperative management with a mean length of hospital stay of 4 ± 1.4 days. One patient required an operative revision due to a stapler line leak after sleeve gastrectomy. No other major postoperative complications occurred.

CONCLUSION

Bariatric surgery for severe high-risk patients can be performed safely in high-volume centers following standardized procedures.

摘要

引言

尽管如今减肥手术具有可行性和安全性,但患有极度肥胖和严重合并症的高危患者围手术期发病率和死亡率相对较高,因此对减肥外科医生构成了独特的挑战。

方法

我们回顾性分析了2012年5月至2016年12月在莱比锡大学医院接受减肥手术的高危患者。当(Bergeat等人,2016年)满足以下至少一项危险因素时定义为高危患者:年龄≥70岁、体重指数(BMI)>70kg/m²、肝硬化、终末器官衰竭或器官移植后因状态导致的免疫抑制,以及(Birkmeyer等人,2010年)至少两种与肥胖相关的合并症。我们的分析包括术后早期并发症。

结果

共确定了25例高危肥胖患者。所有患者均接受标准化术后管理,平均住院时间为4±1.4天。1例患者因袖状胃切除术后吻合器缝线渗漏需要进行手术翻修。未发生其他重大术后并发症。

结论

在大型中心按照标准化程序,可为重度高危患者安全实施减肥手术。

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