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同时手术治疗阿哈拉西亚和肥胖症:一个MBSAQIP分析
Amir Ebadinejad1, Sara Saeidishahri1, Yin Wu1
1Center for Obesity Research, Innovation, and Education, Digestive Health Institute, Hartford HealthCare, Hartford, CT.
概括
同时进行赫勒肌切除术 (HM) 和代谢性减肥手术 (MBS) 会增加术后并发症和住院时间. 对于需要这两种手术的患者来说, 谨慎的时间是至关重要的.
科学领域:
- 外科瘤学
- 胃肠病学
- 减肥手术
背景情况:
- 结合Heller肌切除术 (HM) 和代谢减肥手术 (MBS) 的安全性尚未得到充分证实.
- 现有的数据仅限于病例报告,需要进一步调查.
研究的目的:
- 评估同时使用HM- MBS与单独使用MBS的30天术后结果.
- 为了比较两种手术方法的并发症率和严重程度.
主要方法:
- 对2020-2023年MBSAQIP数据库的回顾性分析.
- 在336名患者 (84名HM-MBS,252名MBS) 中,倾向性得分匹配 (1:3).
- 使用t测试,排列和奇方和费舍尔精确测试对30天结果进行比较.
主要成果:
- HM-MBS组的手术时间和住院时间更长.
- 在HM-MBS中,整体并发症的增加 (27.4%对10.7%),包括肠道出血,SSI,呼吸器支持和败血症.
- 在HM-MBS中增加严重并发症 (CDC等级≥IIIa) (16. 7%对2. 8%),重复手术和重复干预的比率更高.
结论:
- 同时使用HM- MBS与术后发病率显著增加有关.
- 对于需要HM和MBS的患者,建议仔细考虑手术时间.
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