Faculty of Medicine, University of Toronto, Toronto, ON.
Centre for Mental Health, University Health Network, Toronto, ON; Department of Psychiatry, University of Toronto, Toronto, ON; Toronto Western Hospital, Bariatric Surgery Program, Toronto, ON.
Psychosomatics. 2018 Sep-Oct;59(5):452-463. doi: 10.1016/j.psym.2018.03.005. Epub 2018 Mar 21.
Bariatric surgery is an effective weight loss tool that results in sustained weight loss, improvement in obesity-related comorbidities, and positive psychosocial outcomes. However, bariatric procedures also present with risks, as surgical complications are not uncommon.
This study aims to better understand the effect of postoperative complications from bariatric surgeries on patients' psychosocial well-being.
Surgical data on postoperative complications were matched with results from self-administered psychosocial questionnaires. Depression, anxiety, and quality of life (QOL) were assessed preoperatively, and at 1-year postoperatively.
A total of 365 patients were included. Overall, the complication rate was 15.3% (n = 56), with 31 (8.5%) patients experiencing complications within 30 days of surgery, and 25 (6.8%) experiencing late complications. All patients achieved significant weight loss at 1-year postoperatively. Patients with uncomplicated recoveries showed significant improvement in depression (P < 0.001), anxiety (P < 0.001), mental QOL (P < 0.001), and physical QOL (P < 0.001) at 1-year postsurgery. Patients who experienced postoperative complications showed significant improvement in depression (P < 0.001), anxiety (P = 0.04) and physical QOL (P < 0.001), but not in mental QOL (P = 0.210). Despite improved psychosocial outcomes from baseline, patients experiencing complications showed higher postoperative depression scores (P < 0.01) and lower physical QOL (P < 0.01) than patients without complication. Comparison between those with early and late complications did not show significant difference in outcomes.
Complications following bariatric surgery can hinder improvements in patient's psychological well-being and QOL. Bariatric centers should provide more support for patients who have experienced complications.
减重手术是一种有效的减肥手段,可带来持续的体重减轻、肥胖相关合并症的改善以及积极的心理社会结果。然而,减重手术也存在风险,因为手术并发症并不少见。
本研究旨在更好地了解减重手术后并发症对患者心理社会健康的影响。
将术后并发症的手术数据与自我管理的心理社会问卷的结果相匹配。在术前和术后 1 年评估抑郁、焦虑和生活质量(QOL)。
共纳入 365 例患者。总体而言,并发症发生率为 15.3%(n=56),31 例(8.5%)患者在手术后 30 天内发生并发症,25 例(6.8%)发生迟发性并发症。所有患者在术后 1 年均实现了显著的体重减轻。无并发症恢复的患者在术后 1 年时抑郁(P<0.001)、焦虑(P<0.001)、心理健康(P<0.001)和生理健康(P<0.001)显著改善。发生术后并发症的患者在抑郁(P<0.001)、焦虑(P=0.04)和生理健康(P<0.001)方面显著改善,但心理健康(P=0.210)没有改善。尽管与基线相比心理社会结局有所改善,但发生并发症的患者术后抑郁评分更高(P<0.01),生理健康较低(P<0.01),与无并发症的患者相比。早期和晚期并发症患者之间的比较结果无显著差异。
减重手术后的并发症可能会阻碍患者心理幸福感和 QOL 的改善。减重中心应为经历并发症的患者提供更多支持。