体质指数对腹腔镜胰十二指肠切除术后多种并发症、呼吸系统并发症、抢救失败和院内死亡率的影响:一项单中心回顾性研究

IF 1.1 4区 医学 Q3 SURGERY
Xue Wang, Xue Liang, Shupeng Wang, Chun Shang Zhang
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引用次数: 0

摘要

背景:胰十二指肠切除术是胰腺周围肿瘤的标准外科治疗方法。以往的研究表明,高体重指数(BMI)与腹腔镜胰十二指肠切除术(LPD)的不良预后有关。然而,低体重指数与术后并发症之间的关系仍不清楚。材料和方法:对2014年4月至2022年12月期间接受腹腔镜胰十二指肠切除术的1130名患者的临床数据进行了回顾性分析。在对潜在混杂因素进行调整后,利用多变量回归和限制性立方样条分析来探讨 BMI 与短期结果之间的相关性。结果多变量逻辑回归显示,与体重指数正常的患者相比,超重、肥胖或体重严重不足的患者术后发生胰瘘(POPF)的风险更高。此外,肥胖与 "抢救失败 "的比例较高也有显著相关性。体重指数与呼吸系统并发症和院内死亡率呈 "J "形关系,与多种并发症和吻合口漏(胰瘘)呈 "W "形关系,与 "抢救失败 "率呈 "U "形关系。多发性并发症和胰瘘的风险在体重指数分别为 20 和 25 kg/m2 时最低。结论:BMI过高和过低都是LPD术后发生POPF和院内死亡率的风险因素。值得注意的是,体重指数较高和体重严重不足的患者发生 "抢救无效 "的可能性更大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Body Mass Index on Multiple Complications, Respiratory Complications, Failure to Rescue and In-hospital Mortality After Laparoscopic Pancreaticoduodenectomy: A Single-Center Retrospective Study.

Background: Pancreaticoduodenectomy serves as the standard surgical treatment for periampullary tumors. Previous studies have suggested that high body mass index (BMI) is associated with an unfavorable prognosis following laparoscopic pancreaticoduodenectomy (LPD). However, the relationship between low BMI and postoperative complications remains unclear. Materials and Methods: A retrospective analysis of clinical data from 1130 patients who underwent LPD between April 2014 and December 2022 was conducted. Multivariate regression and restricted cubic spline analyses were utilized to explore the correlations between BMI and short-term outcomes, with adjustments for potential confounders. Results: Multivariable logistic regression revealed that overweight, obese, or severely underweight patients had an elevated risk of postoperative pancreatic fistula (POPF) compared to those with a normal BMI. Moreover, obesity was significantly correlated with a higher proportion of "failure to rescue." BMI exhibited a J-shaped relationship with respiratory complications and in-hospital mortality, a W-shaped relationship with multiple complications and anastomotic leakage (pancreatic fistula), and a U-shaped association with "failure to rescue" rates. The lowest risk was observed at BMI levels of 20 and 25 kg/m2 for multiple complications and pancreatic fistula, respectively. Conclusion: Both high and low BMI are identified as risk factors for the occurrence of postoperative POPF and in-hospital mortality following LPD. Notably, patients with higher BMI and severe underweight conditions are associated with an increased likelihood of "failure to rescue."

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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