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减肥手术后早期肠道阻塞:2020-2021年MBSAQIP数据库的分析
Benjamin Clapp1, Kamal Abi Mosleh2, John Corbett1
1Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX.
Surgical laparoscopy, endoscopy & percutaneous techniques
|September 19, 2023
概括
减肥手术后的肠道阻塞是罕见的,最常发生在Roux-en-Y胃绕道 (RYGB) 后,最少发生在袖子胃切除术 (SG) 后. 患有肠道阻塞的RYGB患者也面临更高的再入院和重新手术率.
科学领域:
- 腹腔外科手术的结果
- 胃肠道手术并发症 胃肠道手术并发症
- 代谢和腹部外科手术质量改善
背景情况:
- 代谢和减肥手术认证和质量改进计划 (MBSAQIP) 追踪减肥手术的结果.
- 肠道阻塞 (BO) 被介绍为2020年MBSAQIP参与者使用文件中的30天结果.
- 这项研究比较了腹腔镜Roux-en-Y胃绕道 (RYGB),袖子胃切除术 (SG) 和十二指肠切换器 (DS) 的BO率,危险因素和结果.
研究的目的:
- 为了比较一次性腹腔镜RYGB,SG和DS后早期肠道阻塞 (BO) 的发生率.
- 在这些减肥手术中识别与BO相关的风险因素.
- 为了评估经手术后的结果,包括重新入院和重新手术率,对于经历BO的患者.
主要方法:
- 对2020-2021年MBSAQIP数据的回顾性分析.
- 纳入标准:初级腹腔镜RYGB,SG或DS,用于BMI>35kg/m2的患者.
- 收集的数据包括基线特征,手术细节和30天的术后并发症,重点是BO.
主要成果:
- 总共分析了205533名患者:72.4%的SG,26.5%的RYGB,1%的DS.
- 在SG中,BO率为0.03%,在DS中为0.4%,在RYGB中为0.74%.
- 患有BO的RYGB患者的免疫抑制治疗率更高,手术时间更长. 有BO的SG患者年龄较大,操作时间较长. 患有BO的RYGB患者有最高的再入院率 (71.9%) 和再手术率 (58.4%).
结论:
- 早期肠道阻塞是减肥手术后的罕见并发症.
- 腹腔镜RYGB与早期BO的发病率高于SG和DS相比.
- 经过RYGB治疗并经历BO的患者的再入院和再手术率明显更高.
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