Cappitelli Alex T, McNamara Catherine T, Nuzzi Laura C, Alrayashi Walid, Ganske Ingrid M, Ganor Oren, Labow Brian I
Adolescent Breast Center, Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
Plast Reconstr Surg Glob Open. 2022 Nov 3;10(11):e4641. doi: 10.1097/GOX.0000000000004641. eCollection 2022 Nov.
Obesity is common in adolescents with macromastia seeking surgery, prompting concerns over anesthesia-related complications due to obesity. This may lead to weight-based surgical policies, despite limited research. This study's purpose is to examine the impact of obesity status on perioperative anesthetic-related adverse events/surgical complications in adolescents/young adults undergoing bilateral reduction mammaplasty.
A medical record query was performed to retrospectively identify patients who underwent bilateral reduction mammaplasty at our institution between January 2021 and December 2021. Patient demographics and clinical/surgical data were obtained from medical records. Pearson's chi-square, Fisher exact, and Median tests were used to examine associations between body mass index (BMI) category and clinical/demographic data.
Two hundred patients were included in analyses, with a median age at surgery of 18.0 years. The majority of patients were obese (63.5%, n = 127), and none were underweight. The most common comorbidity was asthma (27.0%, n = 54). There were no anesthetic-related intraoperative complications or delayed waking. The following did not significantly differ by BMI category: proportion of patients who experienced oxygen desaturation (pre-, intra-, or postoperatively), frequency of postoperative complications, and length of postanesthesia care unit and total hospital stays ( > 0.05, all).
While institutions may implement weight-based surgical policies due to anesthesia-related complication concerns in patients with obesity, our study showed that BMI category did not significantly impact anesthetic-related adverse events/surgical complications in our sample. This suggests that such policies are not warranted in all situations, and that decisions regarding their necessity be data-driven.
肥胖在寻求手术治疗的巨乳症青少年中很常见，这引发了对肥胖导致的麻醉相关并发症的担忧。尽管相关研究有限，但这可能导致基于体重的手术政策。本研究的目的是探讨肥胖状态对接受双侧乳房缩小术的青少年/青年围手术期麻醉相关不良事件/手术并发症的影响。
进行病历查询，以回顾性识别2021年1月至2021年12月期间在本机构接受双侧乳房缩小术的患者。从病历中获取患者的人口统计学和临床/手术数据。使用Pearson卡方检验、Fisher精确检验和中位数检验来检验体重指数（BMI）类别与临床/人口统计学数据之间的关联。
200名患者纳入分析，手术时的中位年龄为18.0岁。大多数患者肥胖（63.5%，n = 127），无体重过轻患者。最常见的合并症是哮喘（27.0%，n = 54）。没有麻醉相关的术中并发症或苏醒延迟。以下指标在不同BMI类别之间无显著差异：经历氧饱和度下降（术前、术中或术后）的患者比例、术后并发症发生率、麻醉后护理单元停留时间和总住院时间（均>0.05）。
虽然由于对肥胖患者麻醉相关并发症的担忧，机构可能会实施基于体重的手术政策，但我们的研究表明，BMI类别对我们样本中的麻醉相关不良事件/手术并发症没有显著影响。这表明此类政策并非在所有情况下都有必要，关于其必要性的决策应以数据为依据。
