Taprantzis Nikolaos, Chrysikos Dimosthenis, Troupis Theodore
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Mikras Asias 75, 11527, Athens, Greece.
Aesthetic Plast Surg. 2025 May 12. doi: 10.1007/s00266-025-04870-4.
AIM/BACKGROUND: This review aims to explore the intersection of two significant and timely medical topics: obesity and gender-affirming surgeries. It seeks to determine whether obesity is associated with a higher complication rate in patients undergoing various types of these surgeries. METHODS: A systematic search was conducted using PubMed, Embase and Google Scholar to identify studies meeting the inclusion criteria for this review. Postoperative outcomes were the primary focus, with data analyzed to compare complication rates between patient groups. RESULTS: The first meta-analysis, which compared complication rates based on different BMI ranges, revealed a statistically significant relationship between obesity (BMI ≥ 30 kg/m) and increased postoperative complications. Specifically, obese patients experienced a higher complication rate compared to non-obese patients (BMI < 30 kg/m). The final risk ratio (RR) was 0.46, with 95% confidence intervals (CI) of 0.23 to 0.70. The second meta-analysis assessed the mean BMI of patients who experienced at least one complication versus those who had a complication-free postoperative course. The overall outcome did not differ significantly from zero, indicating no strong connection between BMI and the presence of complications. The final mean difference (MD) was 0.18, with 95% CI ranging from - 0.10 to 0.47. CONCLUSION: BMI is a relevant factor within the broader category of surgical risk factors that medical professionals should carefully consider. Previous systematic reviews and meta-analyses have consistently shown a higher frequency of operative complications in obese patients compared to their non-obese counterparts. Although the precise extent of BMI's influence remains uncertain, obesity should be regarded as a potential contributor to postoperative complications following gender-affirming surgeries. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
目的/背景：本综述旨在探讨两个重要且适时的医学主题的交叉点：肥胖症和性别确认手术。它试图确定肥胖症是否与接受各类此类手术的患者更高的并发症发生率相关。 方法：使用PubMed、Embase和谷歌学术进行系统检索，以识别符合本综述纳入标准的研究。术后结果是主要关注点，对数据进行分析以比较患者组之间的并发症发生率。 结果：第一项荟萃分析根据不同的体重指数（BMI）范围比较并发症发生率，结果显示肥胖症（BMI≥30kg/m²）与术后并发症增加之间存在统计学上的显著关系。具体而言，肥胖患者比非肥胖患者（BMI<30kg/m²）经历更高的并发症发生率。最终风险比（RR）为0.46，95%置信区间（CI）为0.23至0.70。第二项荟萃分析评估了至少发生一次并发症的患者与术后无并发症患者的平均BMI。总体结果与零无显著差异，表明BMI与并发症的存在之间没有紧密联系。最终平均差（MD）为0.18，95%CI范围为-0.10至0.47。 结论：BMI是医学专业人员应仔细考虑的更广泛手术风险因素类别中的一个相关因素。先前的系统评价和荟萃分析一致表明，与非肥胖患者相比，肥胖患者手术并发症的发生率更高。尽管BMI影响的确切程度仍不确定，但肥胖应被视为性别确认手术后术后并发症的一个潜在因素。 证据水平III：本刊要求作者为每篇文章指定一个证据水平。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266。
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