Manueli Laos Emiliano G, Fontaine-Nicola Andres, Zhang Lily, Berger Reed, Abdelhady Khaled, Schlottmann Francisco, Masrur Mario A
Department of Surgery, Division of General, Minimally Invasive & Robotic Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Division of Cardiothoracic surgery, University of Illinois at Chicago, Chicago, United States.
Obes Surg. 2025 Sep 1. doi: 10.1007/s11695-025-08190-z.
Obesity is a major risk factor for many diseases, including cardiovascular disease and cancer, among others. While metabolic and bariatric surgery (MBS) is an effective treatment, pulmonary embolism (PE) remains a concern due to factors like Virchow's triad exacerbated by excess adipose tissue. This study aims to identify perioperative risk factors for PE in patients undergoing MBS to help reduce its incidence.
This study retrospectively analyzed the MBSAQIP PUF database of the year 2023 to identify risk factors for PE within 30 days of sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).
A total of 200865 MBS patients (133,620 SG, 67,245 RYGB) were included in the study; the incidence of 30-day postoperative PE was 0.1% for SG and 0.12% for RYGB. For SG, significant PE risk factors included age, BMI, Black/African American race, history of PE, immunosuppressive therapy, and heart failure. For RYGB, risk factors were age, Black/African American race, history of PE/VTE, dialysis, need for surgical conversion, and mechanical-only VTE prophylaxis.
PE is a rare but potentially fatal post-bariatric surgery complication. The most important risk factor was previous history of thromboembolic events in both cohorts. Individualized risk assessment requires further prospective studies.
肥胖是包括心血管疾病和癌症等多种疾病的主要危险因素。虽然代谢和减重手术（MBS）是一种有效的治疗方法，但由于过多脂肪组织加剧了诸如维勒三联征等因素，肺栓塞（PE）仍然是一个令人担忧的问题。本研究旨在确定接受MBS手术患者围手术期发生PE的危险因素，以帮助降低其发生率。
本研究回顾性分析了2023年MBSAQIP PUF数据库，以确定袖状胃切除术（SG）或Roux-en-Y胃旁路术（RYGB）后30天内发生PE的危险因素。
本研究共纳入200865例MBS患者（133620例SG，67245例RYGB）；SG术后30天PE发生率为0.1%，RYGB为0.12%。对于SG，PE的显著危险因素包括年龄、BMI、黑人/非裔美国人种族、PE病史、免疫抑制治疗和心力衰竭。对于RYGB，危险因素为年龄、黑人/非裔美国人种族、PE/VTE病史、透析、手术转换需求和仅采用机械性VTE预防措施。
PE是减重手术后一种罕见但可能致命的并发症。两个队列中最重要的危险因素都是既往血栓栓塞事件史。个体化风险评估需要进一步的前瞻性研究。
