Ostruszka Petr, Vávra Petr, Tulinský Lubomír, Ihnát Peter
Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
Wideochir Inne Tech Maloinwazyjne. 2020 Sep;15(3):469-477. doi: 10.5114/wiitm.2019.89830. Epub 2019 Nov 18.
Bariatric surgery has a significant impact on dietary intake, weight loss, patient's metabolism and also on defaecation stereotypes.
To investigate changes in bowel habits of morbidly obese patients after laparoscopic sleeve gastrectomy (LSG).
This was a prospective clinical cohort study conducted to assess changes in bowel habits after LSG in a single institution.
In total, 124 patients were enrolled in the study (age 47.1 ±11.2 years, body mass index (BMI) 44.3 ±6.8 kg/m). The mean weight loss 6 months after LSG was 29.1 ±11.1 kg; percentage excess weight loss was 56.2 ±20.4%. Before surgery, 35.5% of patients had constipation and 6.5% of patients had faecal incontinence (FI). No correlation was found between rising level of BMI and constipation or incontinence prevalence/severity. Data analysis has not confirmed increased prevalence/severity of postoperative constipation or incontinence 6 months after LSG. Out of the group of patients with preoperative constipation, clinically relevant improvement was noted in 45.5% of patients after the surgery. Among patients without constipation before surgery, impairment was noted in 21.2% of patients. Out of the group of patients with preoperative incontinence, improvement was found in 37.5% of patients; none of these patients reported clinically relevant impairment of incontinence symptoms.
The present study has not revealed increased prevalence/severity of postoperative constipation or anal incontinence 6 months after LSG. Our findings suggest that weight loss in patients after LSG might be associated with an improvement of constipation symptoms of individual patients.
减肥手术对饮食摄入、体重减轻、患者代谢以及排便模式都有重大影响。
研究病态肥胖患者接受腹腔镜袖状胃切除术(LSG)后排便习惯的变化。
这是一项前瞻性临床队列研究,旨在评估单一机构中LSG术后排便习惯的变化。
共有124名患者纳入研究(年龄47.1±11.2岁,体重指数(BMI)44.3±6.8kg/m)。LSG术后6个月平均体重减轻29.1±11.1kg;超重体重减轻百分比为56.2±20.4%。术前,35.5%的患者有便秘,6.5%的患者有大便失禁(FI)。未发现BMI水平升高与便秘或失禁患病率/严重程度之间存在相关性。数据分析未证实LSG术后6个月便秘或失禁的患病率/严重程度增加。在术前便秘的患者组中,术后45.5%的患者有临床相关改善。术前无便秘的患者中,21.2%的患者出现排便习惯改变。在术前失禁的患者组中,37.5%的患者有改善;这些患者均未报告失禁症状的临床相关损害。
本研究未发现LSG术后6个月便秘或肛门失禁的患病率/严重程度增加。我们的研究结果表明,LSG术后患者体重减轻可能与个体患者便秘症状的改善有关。