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合并症对减重手术后身体塑形手术并发症风险的影响是什么?

What Is the Impact of Comorbidities on the Risk for Postoperative Body-Contouring Surgery Complications in Postbariatric Patients?

机构信息

Post-Graduation Course in Health Sciences, University of Brasília, Brasília, DF, Brazil.

Department of Plastic and Reconstructive Surgery, Asa Norte Regional Hospital, Brasília, DF, Brazil.

出版信息

Obes Surg. 2019 Feb;29(2):552-559. doi: 10.1007/s11695-018-3554-8.

DOI:10.1007/s11695-018-3554-8
PMID:30367325
Abstract

BACKGROUND

There is an increasing number of patients presenting after massive weight loss for plastic surgery, and many of these patients have residual diseases that may compromise outcomes. This study aims to evaluate the impact of comorbidities on the development of postoperative complications in postbariatric patients undergoing plastic surgery procedures at the Federal District North Wing Regional Hospital, Brasília, Brazil.

METHODS

Descriptive, analytical, and prospective study was performed on patients who underwent plastic surgery following RYGB from January 2011 to December 2016. Measures included BMI (body mass index) before RYGB and before plastic surgery, medical complications and comorbidities.

RESULTS

One hundred thirty-nine patients (130 female, 9 male) with a mean age of 41 years underwent 233 separate operations. The average BMI at the time of plastic surgery was 27.44 kg/m. The average weight loss was 47.02 kg, and the mean pre-weight-loss BMI (max BMI) was 45.17 kg/m. The most important pre-plastic comorbidities were arterial hypertension (11.5%), degenerative arthropathy (5.4%), diabetes mellitus (5.0%), and metabolic syndrome (4.3%). Of the 139 patients operated upon, 76.97% underwent abdominoplasty followed by mammoplasty (42.46%). The overall rate of complications was 26.65%. Initially, on univariate regression analyses, comorbidities influenced the development of postoperative complications. However, after multiple logistic regression, the most important comorbidities failed to predict an increased risk of complications.

CONCLUSION

In this group of patients, with these anthropometric and clinical profiles, the most important comorbidities (diabetes, arterial hypertension, and metabolic syndrome) failed to influence the incidence of postoperative complications in postbariatric patients after plastic surgery.

摘要

背景

越来越多的大量减重后的患者寻求整形手术,其中许多患者存在可能影响手术效果的残余疾病。本研究旨在评估巴西巴西利亚联邦区北翼地区医院接受减肥手术后进行整形手术的患者的合并症对术后并发症发生的影响。

方法

对 2011 年 1 月至 2016 年 12 月期间接受 RYGB 术后行整形手术的患者进行描述性、分析性和前瞻性研究。测量指标包括 RYGB 术前和整形术前的 BMI(体重指数)、医疗并发症和合并症。

结果

139 名患者(130 名女性,9 名男性),平均年龄 41 岁,共行 233 例手术。整形手术时的平均 BMI 为 27.44kg/m。平均减重 47.02kg,术前最大 BMI 平均为 45.17kg/m。最重要的术前合并症是高血压(11.5%)、退行性关节炎(5.4%)、糖尿病(5.0%)和代谢综合征(4.3%)。在 139 例手术患者中,76.97%行腹部整形术,其次是乳房整形术(42.46%)。总体并发症发生率为 26.65%。在单变量回归分析中,最初合并症影响术后并发症的发生。然而,在多变量逻辑回归后,最重要的合并症未能预测并发症的风险增加。

结论

在这组患者中,具有这些人体测量和临床特征,最重要的合并症(糖尿病、高血压和代谢综合征)未能影响减肥手术后行整形手术的患者的术后并发症发生率。

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Aesthetic Plast Surg. 2018 Feb;42(1):13-20. doi: 10.1007/s00266-017-0976-y. Epub 2017 Oct 12.
2
Psychological and Psychiatric Traits in Post-bariatric Patients Asking for Body-Contouring Surgery.寻求身体塑形手术的肥胖症患者术后的心理和精神特质
Aesthetic Plast Surg. 2017 Feb;41(1):90-97. doi: 10.1007/s00266-016-0752-4. Epub 2016 Dec 28.
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Evaluation of Diabetes Mellitus as a Risk Factor for Major Complications in Patients Undergoing Aesthetic Surgery.
体重指数与腹壁成形术的修复手术:使用Clavien-Dindo分类法重新审视并发症定义
Plast Reconstr Surg Glob Open. 2023 Feb 13;11(2):e4411. doi: 10.1097/GOX.0000000000004411. eCollection 2023 Feb.
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Complications in post-bariatric body contouring surgery using a practical treatment regime to optimise the nutritional state.采用实用治疗方案优化营养状态的减重术后身体塑形手术并发症
JPRAS Open. 2022 Jun 29;34:91-102. doi: 10.1016/j.jpra.2022.06.006. eCollection 2022 Dec.
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The Impact of Comorbidities on Patient Outcomes in the Upper Body Lift: A Retrospective Review.合并症对上半身提升手术患者预后的影响:一项回顾性研究。
Aesthet Surg J Open Forum. 2022 Jul 28;4:ojac063. doi: 10.1093/asjof/ojac063. eCollection 2022.
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Obes Surg. 2019 May;29(5):1659-1660. doi: 10.1007/s11695-019-03807-6.
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Reply to "The Assessment of a Predictive Risk and a Decrease Postoperative Complication Following Body Contouring Surgery after Massive Weight Loss".对《大量减重后身体塑形手术的预测风险评估及术后并发症减少情况》的回复
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