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无论采用何种手术方式,糖尿病都与减重手术术后更高的死亡率和发病率相关。

Diabetes Is Associated with Worse Postoperative Mortality and Morbidity in Bariatric Surgery, Regardless of the Procedure.

作者信息

Khalil Omar, Dargham Soha, Jayyousi Amin, Al Suwaidi Jassim, Abi Khalil Charbel

机构信息

Research Department, Weill Cornell Medicine-Qatar, Doha P.O. Box 24144, Qatar.

Department of Medicine, Virginia Commonwealth University Health, Richmond, VA 23298, USA.

出版信息

J Clin Med. 2024 May 28;13(11):3174. doi: 10.3390/jcm13113174.

Abstract

: Bariatric surgery is a central cornerstone in obesity treatment. We aimed to assess the impact of diabetes on the postoperative outcomes of bariatric surgery and compare three techniques: sleeve gastrectomy, Roux-en-Y, and gastric banding. : We extracted data from the National Inpatient Sample (2015-2019) using ICD codes. The primary outcome was postoperative mortality. Secondary outcomes were major bleeding, atrial fibrillation, and acute renal failure. : Among patients who underwent sleeve gastrectomy, diabetes was associated with a higher adjusted risk of mortality (aOR 2.07 [1.36-3.16]), atrial fibrillation, and acute renal failure, but a similar risk of bleeding. Among patients who underwent Roux-en-Y, diabetes did not increase mortality and bleeding risk. Still, it was associated with a higher risk of atrial fibrillation and acute renal failure. Among patients who underwent gastric banding, diabetes was only associated with a higher risk of bleeding. When comparing the three techniques in diabetes patients, Roux-en-Y was significantly associated with higher mortality and acute renal failure risk when compared to the other procedures. Bleeding was more common in Roux-en-Y than in Sleeve. : In total, diabetes is associated with worse postoperative outcomes in bariatric surgery, regardless of the technique. Among diabetes patients, Roux-en-Y was associated with the highest mortality and morbidity.

摘要

减重手术是肥胖症治疗的核心基石。我们旨在评估糖尿病对减重手术术后结局的影响,并比较三种手术技术:袖状胃切除术、Roux-en-Y胃旁路术和胃束带术。

我们使用国际疾病分类代码从国家住院患者样本(2015 - 2019年)中提取数据。主要结局是术后死亡率。次要结局是大出血、心房颤动和急性肾衰竭。

在接受袖状胃切除术的患者中,糖尿病与调整后的更高死亡率风险(调整后比值比2.07 [1.36 - 3.16])、心房颤动和急性肾衰竭相关,但出血风险相似。在接受Roux-en-Y胃旁路术的患者中,糖尿病并未增加死亡率和出血风险。不过,它与更高的心房颤动和急性肾衰竭风险相关。在接受胃束带术的患者中,糖尿病仅与更高的出血风险相关。在糖尿病患者中比较这三种手术技术时,与其他手术相比,Roux-en-Y胃旁路术与更高的死亡率和急性肾衰竭风险显著相关。Roux-en-Y胃旁路术的出血比袖状胃切除术更常见。

总体而言,无论采用何种技术,糖尿病都与减重手术更差的术后结局相关。在糖尿病患者中,Roux-en-Y胃旁路术与最高的死亡率和发病率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac6b/11173340/e5f40e069856/jcm-13-03174-g001.jpg

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