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减肥手术不会影响肾结石疾病。

Bariatric surgery does not affect kidney stone disease.

作者信息

Iossa Angelo, Pastore Antonio Luigi, Coluzzi Ilenia, Valenzi Fabio Maria, De Angelis Francesco, Bellini Davide, Lelli Giulio, Cavallaro Giuseppe

机构信息

Division of General Surgery, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Bariatric Centre of Excellence SICOB, Referral Training Center of ISHAWS (Italian Chapter EHS), 'La Sapienza' University of Rome-Polo Pontino, Latina, Italy.

Urology Unit, Faculty of Pharmacy and Medicine, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.

出版信息

Sci Rep. 2024 Dec 4;14(1):30193. doi: 10.1038/s41598-024-78771-y.

Abstract

BACKGROUND

numerous epidemiological studies demonstrate the correlation between obesity and urolithiasis. Bariatric surgery is effective in significant weight loss, reducing mortality rates, and lowering the incidence of obesity-related comorbidities. However, it may be associated with long-term complications such as urolithiasis, with an estimated increase of 7.6% in bariatric patients. This study investigates the impact of various bariatric surgical techniques and personal and nutritional habits on post-operative urolithiasis.

MATERIAL AND METHOD

185 patients were prospectively enrolled in the study. All patients underwent nutritional assessment two years after surgery, and urinary stone disease was evaluated through urinalysis. Patients with urinary crystals were subsequently sent to the division of Urology to evaluate the possible presence of urinary stones through an abdominal CT scan.

RESULTS

kidney stone disease was present in 12 female patients (12/ 185 - 6.49%) out of the 25 (12/25-48%) with urinary crystals. Among the various surgical techniques, 8 patients underwent SG, 2 patients each for OAGB and RYGB, without a proven significant correlation. Hypertension, Dyslipidemia, and OSAS were significantly correlated with the incidence of urolithiasis (p-value < 0.05). BMI > 30 kg/m2 was significantly correlated with urinary stone formation (p-value < 0.05).

CONCLUSION

patients undergoing bariatric surgery should receive counseling about the risk of developing urolithiasis (6.49%) independently from the surgical treatment, highlighting the necessity of adhering to nutritional guidelines. Evaluation for urinary stones could be recommended during follow-up, especially for patients with a BMI > 30 kg/m.

摘要

背景

大量流行病学研究表明肥胖与尿石症之间存在关联。减肥手术在显著减轻体重、降低死亡率以及减少肥胖相关合并症的发生率方面是有效的。然而,它可能与诸如尿石症等长期并发症相关,据估计减肥患者中尿石症的发生率会增加7.6%。本研究调查了各种减肥手术技术以及个人和营养习惯对术后尿石症的影响。

材料与方法

前瞻性纳入185例患者进行研究。所有患者在术后两年接受营养评估,并通过尿液分析评估尿石症。随后,将有尿结晶的患者送至泌尿外科,通过腹部CT扫描评估是否可能存在尿路结石。

结果

在25例有尿结晶的患者中,有12例女性患者(12/185 - 6.49%)患有肾结石。在各种手术技术中,8例患者接受了袖状胃切除术(SG),2例患者分别接受了单吻合口胃旁路术(OAGB)和 Roux-en-Y胃旁路术(RYGB),未发现有经证实的显著相关性。高血压、血脂异常和阻塞性睡眠呼吸暂停综合征(OSAS)与尿石症的发生率显著相关(p值<0.05)。体重指数(BMI)>30 kg/m²与尿路结石形成显著相关(p值<0.05)。

结论

接受减肥手术的患者应接受关于发生尿石症风险(6.49%)的咨询,该风险与手术治疗无关,强调遵守营养指南的必要性。建议在随访期间对尿路结石进行评估,特别是对于BMI>30 kg/m的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8920/11618519/d7fc6fec1960/41598_2024_78771_Fig1_HTML.jpg

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