Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, 51 North 39th Street, Wright Saunders Building, Philadelphia, PA, 19104, United States.
Aesthetic Plast Surg. 2021 Jun;45(3):1105-1112. doi: 10.1007/s00266-020-02046-w. Epub 2020 Nov 16.
With a growing obesity epidemic, an increasing number of patients are seeking body contouring procedures (BCP). The aim of this study was to assess the association of morbid obesity (BMI > 40 kg/m2) with both clinical and health-related quality of life (H-RQOL) outcomes following BCP.
Patients evaluated for post-bariatric BCP at a large academic hospital by one surgeon were retrospectively identified. Patients were surveyed using the BODY-Q during initial and postoperative visits. Demographic, clinical, operative characteristics, and surgical outcomes data were extracted. BODY-Q domain scores were compared between morbidly obese (MO) and non-morbidly obese (NMO). The absolute change in HR-QOL scores for MO and NMO was also compared.
Overall, 59 patients were included (MO 72.9% vs. NMO 27.1%). The median age was 50 years old (Interquartile range [IQR] ± 17); the majority were non-Hispanic (89.8%), non-diabetic (81.4%), non-smokers (67.8%). Assessment of surgical site occurrences, reoperations, and the complication composite outcome revealed no statistical differences between groups (p >0.05). MO patients showed lower net improvement in three HR-QOL domains: satisfaction with body (median 30 [IQR ± 53] vs. 65 [IQR ± 54]; p = 0.036), body image (median 39 [IQR ± 55] vs. 52 [IQR ± 44]; p = 0.025), and social function (median 12 [IQR ± 18] vs. 19 [IQR ± 35]; p = 0.015).
Post-bariatric BCP can be safely performed in the MO patient without increased risk of complication. However, the benefit of truncal BCP is less in MO as it pertains to specific QOL domains: satisfaction with body, body image, and social function.
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随着肥胖症的流行，越来越多的患者寻求身体塑形手术（BCP）。本研究旨在评估病态肥胖（BMI>40kg/m2）与 BCP 后的临床和健康相关生活质量（H-RQOL）结果之间的关联。
对一位外科医生在一家大型学术医院评估的减肥后 BCP 的患者进行回顾性鉴定。患者在初始和术后就诊期间使用 BODY-Q 进行了调查。提取人口统计学、临床、手术特征和手术结果数据。比较病态肥胖（MO）和非病态肥胖（NMO）患者的 BODY-Q 域评分。还比较了 MO 和 NMO 的 HR-QOL 评分的绝对变化。
总体而言，共纳入 59 名患者（MO 占 72.9%，NMO 占 27.1%）。中位年龄为 50 岁（四分位距 [IQR]±17）；大多数为非西班牙裔（89.8%）、非糖尿病（81.4%）、非吸烟者（67.8%）。对手术部位事件、再次手术和并发症综合结果的评估显示两组之间无统计学差异（p>0.05）。MO 患者在三个 HR-QOL 领域的净改善较低：身体满意度（中位数 30[IQR±53] vs.65[IQR±54]；p=0.036）、身体形象（中位数 39[IQR±55] vs.52[IQR±44]；p=0.025）和社会功能（中位数 12[IQR±18] vs.19[IQR±35]；p=0.015）。
在 MO 患者中进行减肥后 BCP 是安全的，没有增加并发症的风险。然而，躯干 BCP 的益处较少，因为它与特定的 QOL 领域有关：身体满意度、身体形象和社会功能。
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