16038Stony Brook School of Nursing, Stony Brook University, Stony Brook, NY, USA.
Department of Surgery, 24998NYU Langone Hospital-Long Island, NYU Long Island School of Medicine, Mineola, New York, USA.
Am Surg. 2022 Jun;88(6):1195-1200. doi: 10.1177/0003134821991975. Epub 2021 Jan 31.
Congestive heart failure (CHF) is a known risk factor for increased postoperative morbidity. However, the safety in patients with CHF has not been well established. The objective of this study was to assess the safety of surgery in patients with a history of CHF undergoing bariatric surgical procedures.
Retrospective review of a prospectively maintained Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center of Excellence database. Patients with known CHF undergoing bariatric procedures over an 11-year period were reviewed.
Over the 11-year period, 4470 total bariatric surgeries were performed, of which 41 (.92%) patients had known CHF. Twenty-one patients were men (51.2%) with a mean age of 55.8 years and mean body mass index (BMI) of 51.9. Comorbidities included hypertension (87.8%), obstructive sleep apnea (80.5%), osteoarthritis (63.4%), gastroesophageal reflux disease (56%), and diabetes (53.7%). Surgical procedures included 16 sleeve gastrectomies (SGs) (39%), 11 Roux-en-Y gastric bypasses (RYGBs) (26.8%), 10 laparoscopic adjustable gastric bands (LAGBs) (24.4%), 1 removal of a gastric band and conversion to SG (2.4%), 1 removal of a gastric band to RYGB (2.4%), 1 gastric band over RYGB pouch (2.4%), and 1 gastric band replacement (2.4%). All cases were performed minimally invasively (73.2% laparoscopic and 26.8% robotic). Mean LOS was 2.53 days. Thirty-day complications included 2 readmissions (4.9% [1 small bowel obstruction and 1 pulmonary edema]), 1 reoperation (2.4% [small bowel obstruction]), and 1 mortality (2.4%) on postoperative day 30 unrelated to the surgery.
Bariatric surgery can be performed safely in patients with CHF.
充血性心力衰竭（CHF）是术后发病率增加的已知危险因素。然而，CHF 患者的安全性尚未得到充分证实。本研究的目的是评估有 CHF 病史的患者接受减肥手术的安全性。
回顾性分析了一个前瞻性维持的代谢和减肥手术认证和质量改进计划（MBSAQIP）卓越中心数据库。在 11 年期间，对接受减肥手术的已知 CHF 患者进行了回顾性分析。
在 11 年期间，共进行了 4470 例减肥手术，其中 41 例（9.2%）患者患有已知的 CHF。21 例患者为男性（51.2%），平均年龄为 55.8 岁，平均体重指数（BMI）为 51.9。合并症包括高血压（87.8%）、阻塞性睡眠呼吸暂停（80.5%）、骨关节炎（63.4%）、胃食管反流病（56%）和糖尿病（53.7%）。手术包括 16 例胃袖状切除术（SG）（39%）、11 例 Roux-en-Y 胃旁路术（RYGB）（26.8%）、10 例腹腔镜可调胃带（LAGB）（24.4%）、1 例胃带移除和转换为 SG（2.4%）、1 例胃带移除至 RYGB（2.4%）、1 例胃带置于 RYGB 袋上（2.4%）和 1 例胃带更换（2.4%）。所有病例均采用微创方法（73.2%腹腔镜和 26.8%机器人）进行。平均 LOS 为 2.53 天。30 天并发症包括 2 例再入院（4.9%[1 例小肠梗阻和 1 例肺水肿]）、1 例再次手术（2.4%[小肠梗阻]）和 1 例 30 天后与手术无关的死亡（2.4%）。
减肥手术可以安全地应用于充血性心力衰竭患者。
