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患者的代谢和减重手术知识是否能预测最佳的临床结果?

Does Patient's Metabolic and Bariatric Surgery Knowledge Predict Optimal Clinical Outcomes?

机构信息

The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Department of Surgery, Carmel Medical Center, 7 Michal St., 3436212, Haifa, Israel.

出版信息

Obes Surg. 2024 Oct;34(10):3857-3865. doi: 10.1007/s11695-024-07474-0. Epub 2024 Aug 28.

Abstract

PURPOSE

Preoperative evaluation and educational training are required before metabolic and bariatric surgery. This study evaluates patient's comprehension prior to the operation and identifies the relationship between certain sociodemographic parameters and surgery outcomes.

MATERIALS AND METHODS

An analysis of patients who completed a preoperative questionnaire and underwent metabolic and bariatric surgery between 2019 and 2021 was performed. The questionnaire evaluated surgery preparation and factors influencing weight loss after surgery.

RESULTS

In total, 81 patients completed the preoperative questionnaire. Mean age was 44 ± 11.69 years, 63 females (77%). Mean BMI was 42.85 ± 5.72 kg/m. Roux-en-Y gastric bypass, sleeve gastrectomy, and one anastomosis gastric bypass was performed in 10 (12.3%), 28 (34%), and 43 (53%) patients respectively. Out of the patients, 38 (47%) were Israeli born Jews, 14 (17.3%) were Russian born Jews, and 29 (35.8%) were Israeli born Arabs. Mean follow-up was 30.71 ± 8.66 months. Questionnaire scores average was 67.7 ± 16.15. Based on univariate analysis, younger, single, higher educated, fewer offspring, and Israeli born Jews significantly scored higher in the questionnaire (p = 0.03, 0.05, 0.01, 0.0002, 0.02 respectively). Postoperational weight loss was significantly inferior among older patients, revisional procedures, and patients with lower educational levels (p = 0.02, 0.006, 0.05 respectively). Patients with a higher BMI, and fewer offspring had a significantly higher weight loss postoperatively (p = 0.0001, 0.02 respectively).

CONCLUSION

The number of factors can influence optimal weight loss following metabolic and bariatric surgery. Identifying groups with certain characteristics and addressing their weaknesses may improve weight loss outcomes.

摘要

目的

代谢和减重手术前需要进行术前评估和教育培训。本研究评估了手术前患者的理解能力,并确定了某些社会人口统计学参数与手术结果之间的关系。

材料和方法

对 2019 年至 2021 年间完成术前问卷并接受代谢和减重手术的患者进行了分析。该问卷评估了手术准备情况和影响手术后体重减轻的因素。

结果

共有 81 名患者完成了术前问卷。平均年龄为 44±11.69 岁,63 名女性(77%)。平均 BMI 为 42.85±5.72kg/m²。行 Roux-en-Y 胃旁路术、袖状胃切除术和单吻合口胃旁路术的患者分别为 10 例(12.3%)、28 例(34%)和 43 例(53%)。患者中,38 例(47%)为以色列出生的犹太人,14 例(17.3%)为俄罗斯出生的犹太人,29 例(35.8%)为以色列出生的阿拉伯人。平均随访时间为 30.71±8.66 个月。问卷评分平均为 67.7±16.15。基于单因素分析,年龄较小、单身、受教育程度较高、子女较少和以色列出生的犹太人在问卷中得分显著较高(p=0.03、0.05、0.01、0.0002、0.02 分别)。年龄较大、再次手术和受教育程度较低的患者术后体重减轻明显较差(p=0.02、0.006、0.05 分别)。BMI 较高和子女较少的患者术后体重减轻明显更高(p=0.0001、0.02 分别)。

结论

影响代谢和减重手术后最佳体重减轻的因素很多。确定具有某些特征的群体并解决他们的弱点可能会改善体重减轻的结果。

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