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袖状胃切除术后使用非甾体抗炎药。

The use of nonsteroidal anti-inflammatory drugs after sleeve gastrectomy.

机构信息

Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

出版信息

Surg Obes Relat Dis. 2021 Mar;17(3):484-488. doi: 10.1016/j.soard.2020.11.016. Epub 2020 Nov 20.

Abstract

BACKGROUND

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is discouraged after bariatric surgery. The effect of NSAIDs on patients who have undergone sleeve gastrectomy (SG) is not well studied. Moreover, the rate of NSAID use after SG is unknown.

OBJECTIVES

To determine the rate of NSAID use after SG, and its associated complications.

SETTING

A single institution, multi-surgeon, academic, tertiary care hospital.

METHODS

We performed a retrospective review of patients who underwent SG between January 1, 2014, and November 1, 2017. A phone interview was conducted with identified patients. The inclusion criteria were any patient who had undergone SG during the study period, and there were no exclusion criteria.

RESULTS

We identified 421 SG patients for inclusion. There were 231 phone surveys completed, with 64.5% of respondents reporting some NSAID use after SG. Of the respondents who used NSAIDs, 40.3% reported that they used the drugs often (>once/wk), 28.2% reported occasional use (>once/mo but <once/wk), and 31.5% reported rare use (<once/mo). Nearly 26% of phone interview respondents regularly used NSAIDs after SG. A retrospective review of the 421-patient cohort revealed 0 cases of sleeve complications secondary to NSAID use when searching for incidences of bleeding, ulceration, gastritis, gastropathy, perforation, leak, or stenosis.

CONCLUSION

NSAID use in our bariatric surgery population is high despite an institutional policy to prohibit their use across all bariatric patients. Despite the high incidence of NSAID use in our patient population, we could not identify a single case of an NSAID-induced gastrointestinal complication in our retrospective review. NSAID use after SG may be a safe and viable pain management strategy that needs further evaluation.

摘要

背景

减重手术后不鼓励使用非甾体抗炎药(NSAIDs)。NSAIDs 对接受袖状胃切除术(SG)患者的影响尚未得到充分研究。此外,SG 后 NSAID 的使用率也不清楚。

目的

确定 SG 后 NSAID 的使用率及其相关并发症。

设置

单机构、多外科医生、学术性、三级保健医院。

方法

我们对 2014 年 1 月 1 日至 2017 年 11 月 1 日期间接受 SG 的患者进行了回顾性研究。对确定的患者进行了电话访谈。纳入标准为研究期间接受 SG 的任何患者,无排除标准。

结果

我们确定了 421 例 SG 患者纳入研究。完成了 231 次电话调查,其中 64.5%的受访者报告在 SG 后使用了某种 NSAID。在使用 NSAIDs 的受访者中,40.3%报告经常使用(>每周一次),28.2%报告偶尔使用(>每月一次但<每周一次),31.5%报告很少使用(<每月一次)。近 26%的电话访谈受访者在 SG 后经常使用 NSAIDs。对 421 例患者队列的回顾性分析显示,在搜索出血、溃疡、胃炎、胃病、穿孔、渗漏或狭窄等与 NSAID 使用相关的 SG 并发症发生率时,没有发现 NSAID 使用导致袖套并发症的病例。

结论

尽管机构政策禁止所有肥胖症患者使用 NSAIDs,但我们的肥胖症手术患者群体中 NSAID 的使用仍然很高。尽管我们的患者群体中 NSAID 的使用发生率很高,但在我们的回顾性研究中,我们没有发现 NSAID 引起的胃肠道并发症的单一病例。SG 后 NSAID 的使用可能是一种安全可行的疼痛管理策略,需要进一步评估。

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