在接受开放腹壁重建的患者中,BMI是否会影响结果? 一个系统的审查和元分析
Syed Ali Farhan1, Syed Husain Farhan2, Jeffrey E Janis3
1Department of General Surgery, Harlem Hospital Center, New York, New York, USA.
World journal of surgery
|June 17, 2025
概括
在接受腹壁重建 (AWR) 的患者中,较高的体重指数 (BMI) 与再入院,再手术和手术部位感染 (SSI) 的风险增加有关. 然而,BMI并没有显著影响AWR患者的复发率.
科学领域:
- 腹壁的重建 腹壁的重建
- 肥胖症和腹部外科手术
- 手术结果研究研究.
背景情况:
- 肥胖是腹壁重建 (AWR) 后并发症的重要危险因素.
- 较高的身体质量指数 (BMI) 往往导致谨慎执行选择性AWR.
- 目前的证据需要综合,以澄清BMI对AWR结果的影响.
研究的目的:
- 为了比较接受AWR的患者的临床结果,按BMI分层.
- 提供基于证据的见解,了解肥胖分类对AWR结果的影响.
主要方法:
- 在PubMed和Cochrane CENTRAL (1966-2024) 的系统文献搜索.
- 包括原始研究,比较BMI<35 kg/m2与BMI≥35 kg/m2的患者接受选择性AWR.
- 使用Mantle-Haenszel随机效应模型进行元分析,以计算聚合几率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 对4769名患者的分析显示,与BMI≥35kg/m2的患者相比,BMI<35kg/m2的患者的再入院 (OR0.52),再手术 (OR0.72) 和手术部位感染 (SSI) (OR0.62) 的几率显著降低.
- 在BMI组之间没有观察到的复发率的统计学上显著差异 (OR 1.03).
结论:
- 患者的BMI不应该是规划选择性AWR的唯一因素,因为它不会影响的复发.
- 接受AWR的肥胖患者应接受关于增加SSI,重新手术和再入院风险的咨询.
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