Department of Surgery, Faculty of Medicine and Health, Örebro University, SE-70185, Örebro, Sweden.
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
Obes Surg. 2020 Jan;30(1):139-145. doi: 10.1007/s11695-019-04108-8.
The benefit of beta-blockade on postoperative outcome remains controversial, though recent studies have suggested a role during major non-cardiac surgery. The benefit of beta-blockade during minimally invasive gastric bypass surgery remains unclear. The aim of the present study was to evaluate the possible association between preoperative beta-blocker therapy and postoperative outcome after laparoscopic gastric bypass surgery.
Patients operated with primary laparoscopic gastric bypass surgery in Sweden between 2007 and 2017 were identified through the Scandinavian Obesity Surgery Registry. The dataset was linked to the Swedish National Patient Registry, the Swedish Prescribed Drug Registry, and Statistics Sweden. The main outcome was serious postoperative complication within 30 days of surgery; with postoperative complication, 90-day and 1-year mortality, and weight loss at 2 years after surgery as secondary endpoints. The Poisson regression model was used to evaluate primary and secondary categorical outcomes. A general mixed model was performed to evaluate 2-year weight loss.
In all, 50281 patients were included in the study. No difference was seen between patients on beta-blockade and the control group regarding postoperative complications (adjusted incidence rate ratio 1.04 (95%CI 0.93-1.15), p = 0.506), serious postoperative complication (adjusted IRR 1.06 95%CI 0.89-1.27), p = 0.515), 90-day mortality (adjusted IRR 0.71 (95%CI 0.24-2.10), p = 0.537), and 1-year mortality (adjusted IRR 1.26 (95%CI 0.67-2.36), p = 0.467). Weight loss 2 years after surgery was slightly greater in patients on beta-blockade (adjusted coefficient 0.53 (95%CI 0.19-0.87), p = 0.002).
Beta-blockade has limited impact on postoperative outcome after laparoscopic gastric bypass surgery.
尽管最近的研究表明β受体阻滞剂在非心脏大手术中有一定作用，但β受体阻滞剂对术后结果的益处仍存在争议。在微创胃旁路手术中，β受体阻滞剂的益处尚不清楚。本研究旨在评估术前β受体阻滞剂治疗与腹腔镜胃旁路手术后术后结果之间的可能关联。
通过斯堪的纳维亚肥胖手术登记处，确定了瑞典在 2007 年至 2017 年间接受初次腹腔镜胃旁路手术的患者。该数据集与瑞典国家患者登记处、瑞典处方药物登记处和瑞典统计局进行了链接。主要结局是手术后 30 天内发生严重术后并发症；次要结局包括术后并发症、90 天和 1 年死亡率以及手术后 2 年的体重减轻。使用泊松回归模型评估主要和次要分类结局。进行一般混合模型以评估 2 年体重减轻。
共有 50281 例患者纳入研究。与对照组相比，服用β受体阻滞剂的患者在术后并发症方面无差异（调整后的发病率比 1.04（95%CI 0.93-1.15），p=0.506）、严重术后并发症（调整后的发病率比 1.06 95%CI 0.89-1.27），p=0.515）、90 天死亡率（调整后的发病率比 0.71（95%CI 0.24-2.10），p=0.537）和 1 年死亡率（调整后的发病率比 1.26（95%CI 0.67-2.36），p=0.467）。服用β受体阻滞剂的患者手术后 2 年的体重减轻略多（调整后的系数 0.53（95%CI 0.19-0.87），p=0.002）。
β受体阻滞剂对腹腔镜胃旁路手术后的术后结果影响有限。
