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肥胖与非肥胖患者经皮放射介导胃造口术安全性及结局的回顾性分析

Retrospective Analysis of the Safety and Outcomes of Percutaneous Radiologic Gastrostomy in Obese vs Nonobese Patients.

作者信息

Sethupathi Sheetal, Walter Kate, Lim Maria, Fang Adam

机构信息

Saint Louis University School of Medicine, St Louis, Missouri, USA.

Saint Louis College of Pharmacy, St Louis, Missouri, USA.

出版信息

JPEN J Parenter Enteral Nutr. 2021 Nov;45(8):1714-1719. doi: 10.1002/jpen.2075. Epub 2021 Mar 15.

Abstract

BACKGROUND

The purpose of this study is to compare the safety and outcomes of percutaneous radiologic gastrostomy (PRG) in obese vs nonobese patients.

METHODS

This is an institutional review board-approved retrospective study of 109 patients (male:female, 68:41; mean age, 64.7 years; range, 21-94 years) who underwent PRG with or without gastropexy at a single academic medical center between 2015 and 2018. Body mass index (BMI) of ≥30 kg/m was defined as obese. Patient demographics, indications, technical success, intraoperative variables, and major/minor complications were analyzed. Major and minor complications occurring within 30 days of the procedure were recorded and categorized based on the Society of Interventional Radiology Quality Improvement guidelines.

RESULTS

Of 109 patients included in the study, 22.9% (n = 25) of patients were obese (average BMI, 34.6 kg/m ; range, 30-50). Overall technical success in the obese and nonobese groups was 100% each. In the obese vs nonobese group, major and minor complications were not significantly different. There were also no significant differences in procedure time, fluoroscopy time, or contrast volume. However, mean peak skin dose was significantly increased in the obese group vs nonobese group (190.3 ± 224.2 vs 59.1 ± 71.1 mGy; P < .0001).

CONCLUSION

PRG is a safe procedure in obese patients with similar technical success, major and minor complication rates, procedure time, fluoroscopy time, and contrast volume. However, PRG is associated with increased radiation dose with obese patients; therefore, optimal methods of radiation protection should be utilized.

摘要

背景

本研究的目的是比较肥胖患者与非肥胖患者经皮放射学胃造口术(PRG)的安全性和结局。

方法

这是一项经机构审查委员会批准的回顾性研究,研究对象为2015年至2018年期间在单一学术医疗中心接受PRG(伴或不伴胃固定术)的109例患者(男:女,68:41;平均年龄64.7岁;范围21 - 94岁)。体重指数(BMI)≥30 kg/m²定义为肥胖。分析患者人口统计学资料、适应证、技术成功率、术中变量以及主要/次要并发症。记录手术30天内发生的主要和次要并发症,并根据介入放射学会质量改进指南进行分类。

结果

在纳入研究的109例患者中,22.9%(n = 25)为肥胖患者(平均BMI,34.6 kg/m²;范围30 - 50)。肥胖组和非肥胖组的总体技术成功率均为100%。肥胖组与非肥胖组相比,主要和次要并发症无显著差异。手术时间、透视时间或造影剂用量也无显著差异。然而,肥胖组的平均皮肤峰值剂量显著高于非肥胖组(190.3±224.2 vs 59.1±71.1 mGy;P <.0001)。

结论

PRG对于肥胖患者是一种安全的手术,在技术成功率、主要和次要并发症发生率、手术时间、透视时间和造影剂用量方面相似。然而,PRG与肥胖患者辐射剂量增加相关;因此,应采用最佳的辐射防护方法。

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