Division of Bariatric Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, 28204, USA.
Surgical Research, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Surg Endosc. 2020 Aug;34(8):3574-3583. doi: 10.1007/s00464-019-07106-0. Epub 2020 Feb 18.
Male patients undergoing bariatric surgery have (historically) been considered higher risk than females. The aim of this study was to examine the disparity between genders undergoing laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) procedures and assess gender as an independent risk factor.
The MBSAQIP® Data Registry Participant User Files for 2015-2017 was reviewed for patients having primary SG and RYGB. Patients were divided into groups based on gender and procedure. Variables for major complications were grouped together, including but not limited to PE, stroke, and MI. Univariate and propensity matching analyses were performed.
Of 429,664 cases, 20.58% were male. Univariate analysis demonstrated males were older (46.48 ± 11.96 vs. 43.71 ± 11.89 years, p < 0.0001), had higher BMI (46.58 ± 8.46 vs. 45.05 ± 7.75 kg/m, p < 0.0001), and had higher incidence of comorbidities. Males had higher rates of major complications (1.72 vs. 1.05%; p < 0.0001) and 30-day mortality (0.18 vs. 0.07%, p < 0.0001). Significance was maintained after subgroup analysis of SG and RYGB. Propensity matched analysis demonstrated male gender was an independent risk factor for RYGB and SG, major complications [2.21 vs. 1.7%, p < 0.0001 (RYGB), 1.12 vs. 0.89%, p < 0.0001 (SG)], and mortality [0.23 vs. 0.12%, p < 0.0001 (RYGB), 0.10 vs. 0.05%; p < 0.0001 (SG)].
Males continue to represent a disproportionately small percentage of bariatric surgery patients despite having no difference in obesity rates compared to females. Male gender is an independent risk factor for major post-operative complications and 30-day mortality, even after controlling for comorbidities.
与女性相比，接受减重手术的男性患者（历史上）被认为风险更高。本研究旨在检查接受腹腔镜袖状胃切除术（SG）和腹腔镜 Roux-en-Y 胃旁路术（RYGB）的患者之间的性别差异，并评估性别是否为独立的危险因素。
对 2015-2017 年 MBSAQIP®数据登记参与者用户文件中接受原发性 SG 和 RYGB 的患者进行回顾性分析。根据性别和手术将患者分为两组。主要并发症的变量被分为一组，包括但不限于 PE、中风和 MI。进行了单变量和倾向匹配分析。
在 429664 例患者中，20.58%为男性。单变量分析表明，男性年龄更大（46.48±11.96 岁 vs. 43.71±11.89 岁，p<0.0001），BMI 更高（46.58±8.46 千克/米 vs. 45.05±7.75 千克/米，p<0.0001），合并症发生率更高。男性主要并发症发生率（1.72% vs. 1.05%；p<0.0001）和 30 天死亡率（0.18% vs. 0.07%，p<0.0001）更高。SG 和 RYGB 的亚组分析后仍保持显著意义。倾向匹配分析表明，男性是 RYGB 和 SG、主要并发症（2.21% vs. 1.7%，p<0.0001（RYGB），1.12% vs. 0.89%，p<0.0001（SG））和死亡率（0.23% vs. 0.12%，p<0.0001（RYGB），0.10% vs. 0.05%；p<0.0001（SG））的独立危险因素。
尽管男性的肥胖率与女性没有差异，但男性在接受减重手术的患者中所占比例仍然不成比例地较小。即使控制了合并症，男性也是主要术后并发症和 30 天死亡率的独立危险因素。
