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肥胖症患者的减重手术:GETAID 的一项病例对照研究。

Bariatric Surgery in Patients With Inflammatory Bowel Disease: A Case-Control Study from the GETAID.

机构信息

Hepato-gastroenterology Departement, CHU Sart Tilman, Liège University, Liège, Belgium.

Abdominal surgery Departement, CHU Sart Tilman, Liège University, Liège, Belgium.

出版信息

Inflamm Bowel Dis. 2022 Aug 1;28(8):1198-1206. doi: 10.1093/ibd/izab249.

Abstract

BACKGROUND

The prevalence of obesity and the number of bariatric surgeries in both the general population and in patients with inflammatory bowel disease (IBD) have increased significantly in recent years. Due to small sample sizes and the lack of adequate controls, no definite conclusions can be drawn from the available studies on the safety and efficacy of bariatric surgery (BS) in patients with IBD. Our aim was to assess safety, weight loss, and deficiencies in patients with IBD and obesity who underwent BS and compare findings to a control group.

METHODS

Patients with IBD and a history of BS were retrospectively recruited to centers belonging to the Groupe d'Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID). Patients were matched 1:2 for age, sex, body mass index (BMI), hospital of surgery, and type of BS with non-IBD patients who underwent BS. Complications, rehospitalizations, weight, and deficiencies after BS were collected in cases and controls.

RESULTS

We included 88 procedures in 85 patients (64 Crohn's disease, 20 ulcerative colitis, 1 unclassified IBD) with a mean BMI of 41.6 ± 5.9 kg/m2. Bariatric surgery included Roux-en-Y gastric bypass (n = 3), sleeve gastrectomy (n = 73), and gastric banding (n = 12). Eight (9%) complications were reported, including 4 (5%) requiring surgery. At a mean follow-up of 34 months, mean weight was 88.6 ± 22.4 kg. No difference was observed between cases and controls for postoperative complications (P = .31), proportion of weight loss (P = .27), or postoperative deficiencies (P = .99).

CONCLUSIONS

Bariatric surgery is a safe and effective procedure in patients with IBD and obesity; outcomes in this patient group were similar to those observed in a control population.

摘要

背景

近年来,普通人群和炎症性肠病(IBD)患者的肥胖患病率和减重手术数量均显著增加。由于样本量小且缺乏足够的对照,因此现有研究无法确定 IBD 患者行减重手术(BS)的安全性和有效性。我们旨在评估 IBD 合并肥胖患者行 BS 的安全性、体重减轻和营养缺乏情况,并与对照组进行比较。

方法

我们回顾性地招募了在炎症性肠病治疗研究组(GETAID)所属中心接受过 BS 的 IBD 患者。将患者按年龄、性别、体重指数(BMI)、手术医院和 BS 类型与非 IBD 行 BS 的患者进行 1:2 配对。收集病例组和对照组患者 BS 后的并发症、再入院、体重和营养缺乏情况。

结果

我们纳入了 85 例患者(64 例克罗恩病、20 例溃疡性结肠炎、1 例未分类 IBD)的 88 例手术,平均 BMI 为 41.6 ± 5.9 kg/m2。BS 包括 Roux-en-Y 胃旁路术(n = 3)、袖状胃切除术(n = 73)和胃束带术(n = 12)。报告了 8 例(9%)并发症,包括 4 例(5%)需要手术。平均随访 34 个月后,患者平均体重为 88.6 ± 22.4 kg。病例组和对照组之间术后并发症(P =.31)、体重减轻比例(P =.27)或术后营养缺乏(P =.99)无差异。

结论

BS 是 IBD 合并肥胖患者安全有效的治疗方法;该患者组的结果与对照组观察到的结果相似。

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