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肥胖人群与非肥胖人群行微创胃切除术后的短期结局:肥胖悖论

Short-term outcomes of minimally invasive gastrectomy in population with obesity versus population without obesity: the obesity paradox.

作者信息

Milone Marco, D'Amore Anna, Baiocchi Gian Luca, Cianchi Fabio, De Manzoni Giovanni, De Pascale Stefano, Degiuli Maurizio, Ercolani Giorgio, Ferrari Giovanni, Fortuna Laura, Fumagalli Romario Uberto, Gualtierotti Monica, Marchesi Federico, Peri Andrea, Puccetti Francesco, Luc Marco Realis, Reddavid Rossella, Rosati Riccardo, Solaini Leonardo, Staderini Fabio, Valente Marina, Viganò Jacopo, Elmore Ugo, Giacopuzzi Simone

机构信息

Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.

Department of Clinical and Experimental Sciences, Surgery, University of Brescia, Brescia, Italy.

出版信息

Updates Surg. 2025 May 3. doi: 10.1007/s13304-025-02144-x.

Abstract

This study aims to compare the short-term outcomes after minimally invasive gastrectomy between obese and non-obese population. Our analysis included data of 713 patients from ten departments of surgery. They were divided in non-obese group and obese group with 617 and 96 patients respectively. Significant differences were found in terms of mortality at 90 days (obese: 0 vs non-obese: 27, p = 0.037). Intraoperative data showed no significant differences in terms of conversion (obese: 4 vs non-obese: 43, p = 0.303). About postoperative complications, significant differences between the two groups were found only in terms of surgical infection (obese: 13 vs non-obese: 38, p = 0.009). About oncological outcomes, no differences were found about retrieved lymph nodes (obese: 30.71 ± 18.44 vs non-obese: 32.93 ± 17.62, p = 0.596) and about surgical radicality (R0) (obese:94 vs non-obese:594, p = 0.415). Obesity doesn't worsen postoperative outcomes and minimally invasive gastrectomy in obese patients is related to a lower postoperative mortality.

摘要

本研究旨在比较肥胖人群和非肥胖人群行微创胃切除术后的短期结局。我们的分析纳入了来自十个外科科室的713例患者的数据。他们被分为非肥胖组和肥胖组,分别有617例和96例患者。在90天死亡率方面发现了显著差异(肥胖组:0例 vs 非肥胖组:27例,p = 0.037)。术中数据显示在中转率方面无显著差异(肥胖组:4例 vs 非肥胖组:43例,p = 0.303)。关于术后并发症,两组之间仅在手术感染方面存在显著差异(肥胖组:13例 vs 非肥胖组:38例,p = 0.009)。关于肿瘤学结局,在获取的淋巴结数量(肥胖组:30.71±18.44个 vs 非肥胖组:32.93±17.62个,p = 0.596)和手术根治性(R0)(肥胖组:94例 vs 非肥胖组:594例,p = 0.415)方面未发现差异。肥胖不会使术后结局恶化,肥胖患者行微创胃切除术与较低的术后死亡率相关。

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