From the Division of Plastic and Reconstructive Surgery, Emory University, Atlanta, GA.
Ann Plast Surg. 2021 Nov 1;87(5):552-555. doi: 10.1097/SAP.0000000000002942.
The objective of this study was to evaluate long-term outcomes and weight loss after panniculectomy.
A retrospective chart review study was performed on 225 consecutive patients who had undergone panniculectomy from 2002 and 2020. Demographic variables including smoking status, medical comorbidities, and prior history of weight loss/bariatric surgery were collected for 173 patients. Preoperative and postoperative body mass index (BMI) were calculated in addition to postoperative outcomes.
The study population was 85% female with a mean age of 57 years and an average follow-up of 3.9 years. Relevant comorbidities included obesity (88%), hypertension (65%), diabetes (37%), and smoking (8%), and the majority (53%) of patients had undergone prior bariatric surgery. The overall complication rate was 40%. Twenty percent of patients required reoperation or readmission, and 20% had minor complications addressed in an outpatient setting. Patients who had higher preoperative BMI experienced a significant long-term reduction in BMI. In addition, patients who did not undergo prior bariatric surgery tended to lose weight more often and by larger amounts than patients who had prior bariatric surgery (71.6% vs 57.6, P = 0.023). Complications were not uncommon and included infection (17%), delayed wound healing (16%), seroma (8%), and hematoma (3%). Patients who had prior bariatric surgery were at reduced risk of any complication (P = 0.012). Smoking increased the incidence of infection (38.5% of smokers vs 15.6% of nonsmokers, P = 0.039). Concomitant hernia repair increased the risk of overall complications (64.3% vs 35.9%, P = 0.003) and delayed wound healing (39.2% vs 11.7%, P < 0.001). In the subgroup of patients who did not lose weight, a panniculus weight greater than 5 kg was associated with an increased complication rate (61.5% vs 27%, P = 0.03).
Patients who underwent a panniculectomy tended to lose weight postoperatively, particularly those who had not undergone previous bariatric surgery. Complications were not uncommon, especially in patients with a smoking history. Prior bariatric surgery patients had a significant decrease in postoperative complications but tended to lose less weight after panniculectomy than those without prior bariatric surgery. Concomitant hernia repair put patients at an increased risk of complications.
本研究旨在评估行腹皮切除术患者的长期结果和减重效果。
回顾性分析了 2002 年至 2020 年期间连续 225 例行腹皮切除术患者的病历资料。173 例患者的人口统计学变量包括吸烟状况、合并症和减重/减重手术史。计算了术前和术后的体重指数（BMI），并评估了术后结果。
研究人群中 85%为女性，平均年龄为 57 岁，平均随访时间为 3.9 年。相关合并症包括肥胖症（88%）、高血压（65%）、糖尿病（37%）和吸烟（8%），其中 53%的患者曾行减重手术。总的并发症发生率为 40%。20%的患者需要再次手术或再次住院，20%的患者在门诊接受了轻微并发症治疗。术前 BMI 较高的患者术后 BMI 长期显著下降。此外，未行减重手术的患者比行减重手术的患者减重更频繁且减重更多（71.6%比 57.6%，P = 0.023）。并发症并不少见，包括感染（17%）、伤口愈合延迟（16%）、血清肿（8%）和血肿（3%）。曾行减重手术的患者发生任何并发症的风险降低（P = 0.012）。吸烟增加了感染的发生率（吸烟者为 38.5%，非吸烟者为 15.6%，P = 0.039）。同时行疝修补术增加了总并发症（64.3%比 35.9%，P = 0.003）和伤口愈合延迟（39.2%比 11.7%，P < 0.001）的风险。在未减重的患者亚组中，腹皮重量大于 5kg 与更高的并发症发生率相关（61.5%比 27%，P = 0.03）。
行腹皮切除术的患者术后体重往往会减轻，尤其是那些未行减重手术的患者。并发症并不少见，尤其是有吸烟史的患者。曾行减重手术的患者术后并发症显著减少，但与未行减重手术的患者相比，术后减重较少。同时行疝修补术会增加患者发生并发症的风险。
