Second Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland; Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Kraków, Poland.
Students' Scientific Group at the Second Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland.
Surg Obes Relat Dis. 2018 Jul;14(7):997-1004. doi: 10.1016/j.soard.2018.03.025. Epub 2018 Mar 26.
Global experiences in general surgery suggest that previous abdominal surgery may negatively influence different aspects of perioperative care. As the incidence of bariatric procedures has recently increased, it is essential to assess such correlations in bariatric surgery.
To assess whether previous abdominal surgery influences the course and outcomes of laparoscopic bariatric surgery.
Seven referral bariatric centers in Poland.
We conducted a retrospective analysis of 2413 patients; 1706 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) matched the inclusion criteria. Patients with no history of abdominal surgery were included as group 1, while those who had undergone at least 1 abdominal surgery were included as group 2.
Group 2 had a significantly prolonged median operation time for RYGB (P = .012), and the longest operation time was observed in patients who had previously undergone surgeries in both the upper and lower abdomen (P = .002). Such a correlation was not found in SG cases (P = .396). Groups 1 and 2 had similar rates of intraoperative adverse events and postoperative complications (P = .562 and P = .466, respectively). Group 2 had a longer median duration of hospitalization than group 1 (P = .034), while the readmission rate was similar between groups (P = .079). There was no significant difference between groups regarding the influence of the long-term effects of bariatric treatment on weight loss (percentage of follow-up was 55%).
Previous abdominal surgery prolongs the operative time of RYGB and the duration of postoperative hospitalization, but does not affect the long-term outcomes of bariatric treatment.
全球普通外科经验表明，既往腹部手术可能会对围手术期护理的多个方面产生负面影响。由于减重手术的发病率最近有所增加，因此评估减重手术中的这些相关性至关重要。
评估既往腹部手术是否会影响腹腔镜减重手术的过程和结果。
波兰 7 个转诊减重中心。
我们对 2413 例患者进行了回顾性分析；1706 例接受腹腔镜袖状胃切除术（SG）或 Roux-en-Y 胃旁路术（RYGB）的患者符合纳入标准。无腹部手术史的患者被纳入第 1 组，而至少接受过 1 次腹部手术的患者被纳入第 2 组。
第 2 组的 RYGB 手术中位手术时间明显延长（P =.012），且在上腹部和下腹部均有既往手术史的患者手术时间最长（P =.002）。在 SG 病例中未发现这种相关性（P =.396）。第 1 组和第 2 组的术中不良事件和术后并发症发生率相似（P =.562 和 P =.466）。第 2 组的中位住院时间长于第 1 组（P =.034），而两组的再入院率相似（P =.079）。两组之间在减重治疗对体重减轻的长期效果的影响方面没有显著差异（随访百分比为 55%）。
既往腹部手术会延长 RYGB 的手术时间和术后住院时间，但不会影响减重治疗的长期效果。
