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术前住院作为体重指数≥50kg/m²的肥胖症手术候选患者体重减轻的过渡策略。

PREOPERATIVE HOSPITALIZATION AS A BRIDGING STRATEGY FOR WEIGHT LOSS IN PATIENTS WITH BODY MASS INDEX = 50 KG/M2 WHO ARE CANDIDATES FOR BARIATRIC SURGERY.

作者信息

Severo Renata Ramos, Santa-Cruz Fernando, Kreimer Flávio, Sena André Bezerra de, Ferraz Álvaro Antônio Bandeira

机构信息

Universidade Federal de Pernambuco, Postgraduate in Surgery - Recife (PE), Brazil.

Hospital dos Servidores do Estado, General Surgery Service - Recife (PE), Brazil.

出版信息

Arq Bras Cir Dig. 2025 Jan 20;37:e1852. doi: 10.1590/0102-6720202400058e1852. eCollection 2025.

Abstract

BACKGROUND

Preoperative hospitalization with the purpose to obtain more effective weight loss provides intensive care for patients who have a higher body mass index (BMI) and associated diseases that involve a greater risk of peri- and postoperative complications. It is a therapeutic strategy that can make it possible to overcome obstacles related to the difficulty of adhering to obesity treatment.

AIMS

To analyze the implementation of a preoperative hospitalization strategy for weight loss in patients eligible for bariatric surgery.

METHODS

Retrospective study that included 194 patients with a BMI=50 kg/m2. They were grouped according to preoperative preparation strategies: inpatient (n=32) and outpatient (n=162), who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2010 and 2020. The groups were compared regarding preoperative weight loss before and after the strategies and postoperative up to two years after surgery.

RESULTS

Most patients were female and there were significant differences in age group (an average of 42.94 years in the preoperative hospitalization strategy group and 37.73 in the outpatient strategy group). The mean BMI in the hospitalized group was 63.01±8.72 kg/m2, and in the outpatient group it was 54.95±4.31 kg/m2. There was a significant difference only between initial and preoperative weight in the hospitalized group. Furthermore, the difference between initial weight and last recorded weight up to two years after surgery was significant in each group. The occurrence of associated diseases was higher in the outpatient group.

CONCLUSIONS

Patients following the preoperative hospitalization strategy experienced significant weight loss before surgery.

摘要

背景

术前住院以实现更有效的体重减轻,为体重指数(BMI)较高且伴有相关疾病的患者提供强化护理,这些疾病会增加围手术期和术后并发症的风险。这是一种治疗策略,能够克服肥胖治疗依从性困难相关的障碍。

目的

分析符合减重手术条件的患者术前住院减重策略的实施情况。

方法

回顾性研究纳入了194例BMI = 50 kg/m²的患者。根据术前准备策略将他们分组:住院组(n = 32)和门诊组(n = 162),这些患者在2010年至2020年期间接受了 Roux-en-Y 胃旁路术(RYGB)或袖状胃切除术(SG)。比较两组在策略实施前后的术前体重减轻情况以及术后长达两年的情况。

结果

大多数患者为女性,年龄组存在显著差异(术前住院策略组平均年龄为42.94岁,门诊策略组为37.73岁)。住院组的平均BMI为63.01±8.72 kg/m²,门诊组为54.95±4.31 kg/m²。仅住院组的初始体重与术前体重之间存在显著差异。此外,每组术后两年内初始体重与最后记录体重之间的差异均显著。门诊组相关疾病的发生率更高。

结论

遵循术前住院策略的患者在手术前体重显著减轻。

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