Bamehriz Fahad, Althuwaini Saad, Alobaid Omar, Alanazi Yara, Alotaibi Rawan, Alfuweres Nawt, Alsaikhan Najla, Almanie Waad, Alghafaily Munira, Aldohayan Abdulla
Division of Surgery, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Saudi J Anaesth. 2018 Oct-Dec;12(4):555-558. doi: 10.4103/sja.SJA_140_18.
Super-morbid obese (SMO) patients (body mass index [BMI] >50 kg/m) carry a higher risk for bariatric surgery. Despite several studies addressing this patient group, the number of patients included tends to be relatively small.
We reviewed 708 patients who underwent laparoscopic sleeve gastrectomy between 2009 and 2015 and compared the outcome of SMO (BMI ≥50 kg/m) patients with MO (BMI <50 kg/m) patients.
Of 708 patients, 217 were SMO and 491 were MO. Both groups had homogeneous baseline characteristics and comorbidities, except sleep apnea which was higher in SMO group. There was no significant difference for the duration of operation, length of stay, or recovery room time. The mean number of trocars was four for both groups. There were no conversions to open or documented intraoperative complications in either group. Postoperative complications occurred in 13 (6%) SMO patients (3 patients with leakage and 10 with bleeding). Postoperative complications occurred in 21 (4.3%) MO patients (11 patients with leakage and 10 with bleeding). No reoperation was done in both groups. There was no surgical mortality.
We detected no significant difference in the duration of operation and intra- or postoperative complication between SMO and MO groups. The possibility of the safety of this procedure in SMO group can be adopted.
超级病态肥胖(SMO)患者(体重指数[BMI]>50kg/m²)接受减肥手术的风险更高。尽管有多项研究针对这一患者群体,但纳入的患者数量往往相对较少。
我们回顾了2009年至2015年间接受腹腔镜袖状胃切除术的708例患者,并比较了SMO(BMI≥50kg/m²)患者与MO(BMI<50kg/m²)患者的手术结果。
在708例患者中,217例为SMO,491例为MO。两组患者的基线特征和合并症相似,但SMO组的睡眠呼吸暂停发生率更高。手术时间、住院时间或恢复室停留时间无显著差异。两组的平均套管针数量均为4个。两组均未转为开放手术或记录有术中并发症。13例(6%)SMO患者发生术后并发症(3例渗漏,10例出血)。21例(4.3%)MO患者发生术后并发症(11例渗漏,10例出血)。两组均未进行再次手术。无手术死亡病例。
我们发现SMO组和MO组在手术时间以及术中或术后并发症方面无显著差异。该手术在SMO组的安全性是可行的。