肥胖对性结肠炎术后并发症的影响:系统性审查和元分析
L M Tóth1, H Székely1, A Rancz1
1Centre for Translational Medicine Semmelweis University Budapest Hungary.
Annals of gastroenterological surgery
|January 6, 2025
概括
在接受直肠切除术的性结肠炎患者中,肥胖 (BMI > 30) 并没有显著增加整体术后并发症. 人们注意到住院时间增加,但肥胖和非肥胖患者的整体并发症风险仍然相似.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床流行病学临床流行病学
背景情况:
- 性结肠炎 (UC) 影响大约200/100,000个人.
- 结肠切除术是UC的常见手术,7.5%-40%的患者需要它.
- 几乎一半的成年UC患者超重或肥胖,这是可能影响手术结果的因素.
研究的目的:
- 为了比较肥胖患者 (BMI > 30 kg/m2) 和非肥胖UC患者的手术后并发症,这些患者在经过全方位结肠切除术与阴道囊-门解剖 (IPAA) 后.
- 评估肥胖对接受IPAA的UC患者手术结果的影响.
主要方法:
- 按照PRISMA 2020指南,对三个数据库进行系统搜索 (2022年11月).
- 包括三项追溯队列研究,涉及4929名UC患者,他们接受了IPAA的集体切除术.
- 使用随机效应模型进行元分析,以汇集手术后并发症的数据,用于二分法和连续变量平均差异的几率比率 (OR) 和平均差异 (MD).
主要成果:
- 肥胖和非肥胖UC患者之间的30天整体术后并发症 (OR = 1.08) 或败血症并发症 (OR = 1.11) 没有显著差异.
- 在肥胖患者中观察到住院时间的统计显著增加 (MD = 0.36天).
- 调查结果的证据确定性被评为非常低,这是由于包含的研究中存在中度偏差风险.
结论:
- 肥胖 (BMI > 30 kg/m2) 似乎与UC患者的IPAA后整体术后并发症风险显著增加无关.
- 观察到的住院时间的增加值得考虑,但并不禁忌进行手术.
- 仅仅是肥胖,使用BMI截止值为30 kg/m2,可能不是这组患者需要预康复的主要因素.
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