GERD Is Associated with Higher Long-Term Reoperation Rates After Bariatric Surgery
GERD Is Associated with Higher Long-Term Reoperation Rates After Bariatric Surgery
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DOI：
10.1007/s11605-015-2993-y
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发表时间：
2016-01-01
影响因子：
3.2
通讯作者：
Steele, Kimberley E.
中科院分区：
文献类型：
--
作者：
Obeid, Tammam;Krishnan, Aravind;Steele, Kimberley E.
虽然减肥手术是一种安全有效的治疗病态肥胖的方法，但长期再次手术仍然是患者发病率和死亡率的重要来源。我们对2009至2013年间在我们机构接受腹腔镜胃分流术(LGBP)或腹腔镜袖状胃切除术(LSG)的所有患者进行了回顾分析。利息的主要结果是截至目前的再手术率。最终的Logistic回归模型包括年龄、性别、手术时体重指数、种族(高加索人与非裔美国人)、手术时间、住院时间、糖尿病病史、胃食道反流病(GERD)病史、手术类型和再入院情况。总再手术率为9.0%，平均随访43.9个月(中位数45个月)。当按种族分层时，高加索人术前GERD与再手术风险显著增加2.2倍相关(OR 2.2，95%CI 1.0-4.8，P=.043)。非洲裔美国人的GERD风险略有增加，但并不显著。其他重要的预测因素包括住院时间和再入院时间(OR2.1，P=0.029；OR5.0，P<；0.000)。高加索肥胖患者术前胃肠道反流病与再次手术的风险较高。住院时间长和腹腔镜术后30天内再次住院是再次手术率较高的独立预测因素。
Although bariatric surgery is a safe and effective treatment for morbid obesity, long-term reoperation remains a significant source of morbidity and mortality for the patient.We performed a retrospective analysis of all patients undergoing laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) surgeries at our institution between 2009 and 2013. Main outcome of interest was reoperation rate up to current date. Final logistic regression model included age, gender, BMI at time of operation, race (Caucasian vs African American), surgery time, length of stay, history of diabetes, history of gastroesophageal reflux disease (GERD), type of surgery, and readmission.A total of 533 patients underwent either LGBP or LSG surgery between 2009 and 2013. Overall reoperation rate was 9.0 % and mean follow-up was 43.9 months (median 45). When stratified by race, preoperative GERD in Caucasians was associated with a significant 2.2-fold increased risk of reoperation (OR 2.2, 95% CI 1.0-4.8, P = .043). GERD in African Americans had a small nonsignificant increased risk. Other significant predictors included length of stay and readmission (OR 2.1, P = 0.029; OR 5.0, P < 0.000).Preoperative GERD in Caucasian bariatric patients is associated with a higher risk of reoperation. Lengthy hospital stay and readmission within 30 days of laparoscopic bariatric surgery are independent predictors of higher reoperation rates.