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胃旁路术后慢性腹痛的风险因素:患者术前是否得到充分选择?

Risk Factors for Chronic Abdominal Pain After RYGB: Are Patients Adequately Selected Beforehand?

机构信息

Imperial Weight Centre, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK.

West London NHS Trust, Southall, UK.

出版信息

Obes Surg. 2024 May;34(5):1748-1755. doi: 10.1007/s11695-024-07193-6. Epub 2024 Apr 5.

Abstract

PURPOSE

Chronic abdominal pain after RYGB is a known issue. Identifying the potential patient-related and modifiable risk factors might contribute to diminish the risk for this undesirable outcome.

METHODS

A single-center retrospective cohort study with prospective data collection was conducted with inclusion of all patients who underwent RYGB surgery between 2015 and 2021. Data from the NBSR and medical records were used. Patients with chronic abdominal pain were defined when pain lasting or recurring for more than 3 to 6 months.

RESULTS

Six hundred sixty-four patients who underwent RYGB surgery were included with a median follow-up of 60.5 months. Forty-nine patients (7.3%) presented with chronic abdominal pain. Postoperative complications (OR 13.376, p = 0.020) and diagnosis of depression (OR 1.971, p = 0.037) were associated with developing abdominal pain. On the other hand, ex-smokers (OR 0.222, p = 0.040) and older age (0.959, p = 0.004) presented as protective factors.

CONCLUSION

Postoperative complications and diagnosis of depression are risk factors for chronic pain after RYGB. The role of the bariatric MDT remains crucial to select these patients adequately beforehand.

摘要

目的

RYGB 术后慢性腹痛是已知问题。确定潜在的与患者相关和可改变的风险因素可能有助于降低这种不良结果的风险。

方法

这是一项单中心回顾性队列研究,前瞻性收集数据,纳入了 2015 年至 2021 年间接受 RYGB 手术的所有患者。使用 NBSR 和病历数据。当疼痛持续或复发超过 3 至 6 个月时,将患者定义为患有慢性腹痛。

结果

共纳入 664 例接受 RYGB 手术的患者,中位随访时间为 60.5 个月。49 例(7.3%)患者出现慢性腹痛。术后并发症(OR 13.376,p=0.020)和抑郁诊断(OR 1.971,p=0.037)与腹痛发生相关。另一方面,戒烟(OR 0.222,p=0.040)和年龄较大(OR 0.959,p=0.004)是保护因素。

结论

术后并发症和抑郁诊断是 RYGB 后慢性疼痛的危险因素。肥胖多学科团队的作用仍然至关重要,以便在术前充分选择这些患者。

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