肥胖对泌尿外科形手术结果的影响:系统性审查和元分析
Nancy E Ringel1, Stacy M Lenger, Rachel High
1Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville, Louisville, Kentucky; the Division of Urogynecology, Department of Obstetrics and Gynecology, Houston Methodist, Houston, the Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, and the Department of Obstetrics and Gynecology, University of Texas at Austin Dell Medical School, Austin, Texas; the Department of Obstetrics and Gynecology, Royal Columbian Hospital, University of British Columbia, Vancouver, British Columbia, Canada; the Division of Female Urology and Pelvic Reconstructive Surgery, Department of Urology, University of California, Irvine, Orange, the Department of Obstetrics and Gynecology, University of California, Riverside School of Medicine, Riverside, and KPC Healthcare, Hemet, California; the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; the Department of Obstetrics and Gynecology, University of Florida Health, Jacksonville, and Bela Vida Urogynecology, Celebration, Florida; the Division of Urogynecology, Department of Obstetrics and Gynecology, Cooper Health University, Camden, New Jersey; the Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; the International Medical Response Foundation, Brooklyn, and the Departments of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, New York; and the Center for Evidence Synthesis in Health, Brown School of Public Health, Brown University, Providence, Rhode Island.
肥胖会增加骨盆器官脱落 (POP) 复发和手术修复后的网状并发症的风险. 这一系统性审查强调了较高的体重指数 (BMI) 对这些手术结果的影响.
科学领域:
- 泌尿后科和骨盆重建外科手术
- 手术结果研究研究.
- 肥胖医学 肥胖医学
背景情况:
- 骨盆器官脱落 (POP) 影响了大量女性,手术干预是常见的治疗方法.
- 体重指数 (BMI) 定义的肥胖在POP手术结果中的作用仍然是积极研究的领域.
- 了解BMI对POP手术的影响对于患者咨询和手术规划至关重要.
研究的目的:
- 系统地审查现有的有关不同BMI类别的POP手术结果的文献.
- 确定肥胖与手术成功率,复发率和并发症之间的关联.
- 综合有关不同程度的肥胖对POP修复的影响的证据.
主要方法:
- 在PubMed,EMBASE和Cochrane数据库中进行全面的文献搜索,截至2022年4月,并在2022年9月进行临床试验.gov.
- 包括随机和非随机研究,比较不同BMI或肥胖类别的POP手术结果.
- 数据提取和对结果的元分析,包括主观,客观和各肥胖分类中的并发症率.
主要成果:
- 分析显示,肥胖 (BMI ≥30) 与阴道修复 (OR 1.38) 和所有手术方法 (OR 1.31) 后客观性脱落复发的可能性更高.
- 肥胖也与阴道和腹腔镜POP修复后的网状暴露并发症风险增加有关 (OR 2.10).
- 个别研究显示出不同的结果,但元分析提供了一个更清晰的关于肥胖影响的图片.
结论:
- 肥胖是一个重要的因素,与手术修复后倒复发的几率增加有关.
- 体重指数较高的患者有较高的网状相关并发症风险,例如暴露,POP后手术.
- 这些发现强调了在管理和手术决策中考虑BMI的重要性.
相关概念视频
Drug Dosing: Obese Patients
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion


