Department of General, Visceral and Transplant Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Department of General, Visceral and Bariatric Surgery, Plastic Surgery, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany.
Langenbecks Arch Surg. 2022 Feb;407(1):321-326. doi: 10.1007/s00423-021-02299-2. Epub 2021 Aug 31.
Bariatric surgery is on the rise worldwide. With the desired weight loss after bariatric surgery, patients frequently develop massive skin flaps resulting in the need of abdominoplasty. In these patients, this surgical technique is frequently associated with perioperative complications. Strategies to minimize complications are sought after. The objective of our study was to compare two different dissection techniques and their impact on postoperative outcome.
We included 66 patients in our study who underwent abdominoplasty after massive weight loss following bariatric surgery. In group 1, abdominoplasty was performed using the conventional technique of diathermia (n = 20). In group 2, abdominoplasty was performed using LigaSure Impact™ (n = 46). The duration of the surgical procedure and perioperative complications were recorded as primary endpoints. Secondary endpoints were length of hospital stay and assessment of additional risk factors.
Baseline characteristics were comparable between groups. The duration of surgery was significantly shorter in group 2. Postoperative complications were significantly less frequent in group 2 (p = 0.0035). Additional risk factors, e.g., smoking and diabetes mellitus, were not associated with increased rates of perioperative complications.
The choice of technical device for dissection in abdominoplasty alone will not guarantee minimized complication rates. Yet, the utilization of LigaSure Impact™ in refined surgical techniques may facilitate reduced rates of complications, especially wound infections, and a shortened duration of surgery.
减重手术在全球范围内呈上升趋势。患者在接受减重手术后体重减轻,常出现大量皮肤瓣,需要进行腹部整形术。在这些患者中,这种手术技术常伴有围手术期并发症。因此,人们寻求降低并发症的策略。本研究的目的是比较两种不同的解剖技术及其对术后结果的影响。
我们纳入了 66 例在减重手术后大量体重减轻后接受腹部整形术的患者。在第 1 组中,使用电灼常规技术(n=20)进行腹部整形术。在第 2 组中,使用 LigaSure ImpactTM(n=46)进行腹部整形术。记录手术过程的持续时间和围手术期并发症作为主要终点。次要终点为住院时间和评估其他危险因素。
组间基线特征无差异。第 2 组的手术时间明显缩短。第 2 组的术后并发症明显较少(p=0.0035)。其他危险因素,如吸烟和糖尿病,与围手术期并发症发生率增加无关。
单独进行腹部整形术时,解剖技术设备的选择并不能保证降低并发症发生率。然而,在精细的手术技术中使用 LigaSure ImpactTM 可能有助于降低并发症发生率,尤其是伤口感染率,并缩短手术时间。