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减重手术后的下体提升术:10 年经验中的 323 例连续病例。

Lower Body Lift After Bariatric Surgery: 323 Consecutive Cases Over 10-Year Experience.

机构信息

Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 67, 56125, Pisa, Italy.

Plastic Surgery Unit, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil.

出版信息

Aesthetic Plast Surg. 2020 Apr;44(2):421-432. doi: 10.1007/s00266-019-01543-x. Epub 2019 Nov 20.

Abstract

BACKGROUND

Lower body lift is a widespread procedure for massive weight loss patients aimed to improve the contour of the lower trunk, gluteal region and proximal lower extremity. The data about complications are confusing, and there is a lack of uniform studies for massive weight loss patients. A simple formula to carry out a reliable procedure in a short time with a low complication rate should be advocated.

METHODS

This retrospective study analyzed data of 323 patients undergoing lower body lift after bariatric surgery over a 10-year period. Selection criteria, careful preoperative marking, reliable intra- and postoperative care and a few surgical tips are discussed. All the complications (both major and minor) and the aesthetic satisfaction were evaluated. Risk factors assessed were patient age, tobacco consumption, current BMI, operative time and combined surgery.

RESULTS

The overall complication rate was 42%. We recorded a lower rate of major complications and skin dehiscence; no infection and no skin necrosis were observed. The most frequent complication was seroma (35%). A complication development was straight related to age (p = 0.0177) and tobacco use (p = 0.0336). Patients' satisfaction about overall aesthetic was high.

CONCLUSIONS

We present our case load and describe an easy recipe to perform a safe surgery without undermining and liposuction in short operative times. The reasonable overall complication rate and the surprisingly lower rate of dehiscence and skin necrosis combined with a pleasant aesthetic result make the lower body lift an easy and safe procedure, when applied to the appropriate patient population.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

摘要

背景

下半身提升术是一种广泛应用于大量减重患者的手术,旨在改善下躯干、臀部区域和近端下肢的轮廓。关于并发症的数据存在混淆,而且缺乏针对大量减重患者的统一研究。应该提倡一种简单的公式,以便在短时间内以低并发症率进行可靠的手术。

方法

本回顾性研究分析了 10 年间 323 例接受减重手术后下半身提升术患者的数据。讨论了选择标准、仔细的术前标记、可靠的围手术期护理和一些手术技巧。评估了所有并发症(包括主要和次要并发症)和美学满意度。评估的风险因素包括患者年龄、吸烟状况、当前 BMI、手术时间和联合手术。

结果

总的并发症发生率为 42%。我们记录了较低的主要并发症和皮肤裂开发生率;未观察到感染和皮肤坏死。最常见的并发症是血清肿(35%)。并发症的发生与年龄(p=0.0177)和吸烟状况(p=0.0336)直接相关。患者对整体美学效果的满意度较高。

结论

我们介绍了我们的病例,并描述了一种简单的方法,即在短手术时间内进行安全的手术,无需潜行和吸脂。合理的总并发症发生率以及出乎意料的较低的裂开和皮肤坏死发生率,加上令人愉悦的美学效果,使得下半身提升术成为一种简单且安全的手术,适用于适当的患者群体。

证据水平 IV:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266。

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