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肥胖对甲状腺切除术结果的影响:一项病例匹配研究。

The impact of obesity on thyroidectomy outcomes: a case-matched study.

机构信息

Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.

Section of Statistics, University of Pisa, Pisa, Italy.

出版信息

Updates Surg. 2024 Jan;76(1):219-225. doi: 10.1007/s13304-023-01687-1. Epub 2023 Nov 21.

Abstract

Obesity is a well-known public health concern in Western World. Accordingly, an elevated number of obese patients undergo thyroidectomy every year. We aim to assess the impact of obesity on intraoperative and postoperative outcomes of patients who undergo thyroidectomy. 1228 patients underwent thyroidectomy at our department between January 2021 and September 2021. We divided patients into two groups according to body mass index (BMI): non-obese (BMI < 30 kg/m) and obese (BMI ≥ 30 kg/m). A propensity score approach was performed to create 1:1 matched pairs (matching according to age, gender, diagnosis, nodule size and type of operation). After matching, the final population included 522 patients, equally divided between each group: non-obese group (Group A; n = 261) and obese group (Group B; n = 261). The primary endpoint of the study was the overall rate of postoperative complications; secondary endpoints of the study were operative time, use of energy device and length of hospital stay. The duration of hospital stay resulted longer in Group B (p = 0.002). No statistically significant differences were documented in terms of operative time (p = 0.206), use of energy devices (p = 0.855) and surgical complications (p = 0.429). Moreover, no statistically significant differences were documented considering each specific complication: transient and permanent hypocalcemia (p = 0.336; p = 0.813, respectively), transient and permanent recurrent laryngeal nerve palsy (p = 0.483; p = 0.523, respectively), hematoma (p = 0.779), bleeding (p = 0.178), wound infection (p = 0.313) and cheloid formation (p = 0.412). Thyroidectomy can safely be performed in obese patients. Outcomes resulted comparable; nonetheless, obesity correlates to longer hospital stay.

摘要

肥胖是西方世界众所周知的公共卫生问题。相应地,每年有大量肥胖患者接受甲状腺切除术。我们旨在评估肥胖对接受甲状腺切除术的患者术中及术后结果的影响。2021 年 1 月至 2021 年 9 月期间,我院共对 1228 例患者进行了甲状腺切除术。我们根据体重指数(BMI)将患者分为两组:非肥胖组(BMI<30kg/m)和肥胖组(BMI≥30kg/m)。采用倾向评分匹配法(根据年龄、性别、诊断、结节大小和手术类型进行匹配)创建 1:1 匹配对。匹配后,最终纳入的患者群体包括 522 例患者,每组各 261 例:非肥胖组(A 组;n=261)和肥胖组(B 组;n=261)。研究的主要终点是术后总体并发症发生率;次要终点是手术时间、能量器械的使用和住院时间。B 组患者的住院时间明显延长(p=0.002)。手术时间(p=0.206)、能量器械使用(p=0.855)和手术并发症(p=0.429)方面无统计学显著差异。此外,考虑到每种特定的并发症,也无统计学显著差异:暂时性和永久性低钙血症(p=0.336;p=0.813)、暂时性和永久性喉返神经麻痹(p=0.483;p=0.523)、血肿(p=0.779)、出血(p=0.178)、伤口感染(p=0.313)和瘢痕疙瘩形成(p=0.412)。肥胖患者可安全地进行甲状腺切除术。结果相似;尽管如此,肥胖与住院时间延长相关。

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