PDF(Pubmed)
Abstract：
OBJECTIVE: Although bariatric surgery is an effective intervention for obesity, it comes with risks such as early postoperative bleeding (EPB). Identifying preoperative risk factors for this complication can help patients\' risk stratification and optimization. We performed a systematic review and meta-analysis to find predictors for early postoperative bleeding after Roux-en-Y gastric bypass (RYGB).
METHODS: We conducted a systematic review, searching PubMed, Cochrane Library, and Web of Science until November 2023. We performed a random-effects meta-analysis to explore preoperative risk factors associated with early postoperative bleeding after RYGB. Sources of heterogeneity were explored by leave-one-out analyses.
RESULTS: 23 studies were included, comprising 232,488 patients. Male gender (meta-analytical RR = 1.42, 95%CI = 1.21-1.66, I2 = 18%, Q Cochran test p-value = 0.29) and revisional surgery (meta-analytical RR = 1.35, 95%CI = 1.12-1.62, I2 = 22%, Q Cochran test p = 0.21) were associated with higher risk of EPB. On average, patients with EPB were older than the remainder (MD for the mean age = 2.82 years, 95%CI = 0.97-4.67, I2 = 0.00%, Q Cochran test p = 0.46). Except for hypertension (meta-analytical RR = 1.33, 95%CI = 1.02-1.73, I2 = 66%, Q Cochran test p < 0.0001), comorbidities were not associated with a higher risk of EPB.
CONCLUSIONS: Preoperative risk factors, including age, gender, hypertension, and revisional bariatric surgery, are associated with early postoperative bleeding after RYGB. Further primary studies, with higher methodological quality, are required to detail more risk factors.
METHODS: We conducted a systematic review, searching PubMed, Cochrane Library, and Web of Science until November 2023. We performed a random-effects meta-analysis to explore preoperative risk factors associated with early postoperative bleeding after RYGB. Sources of heterogeneity were explored by leave-one-out analyses.
RESULTS: 23 studies were included, comprising 232,488 patients. Male gender (meta-analytical RR = 1.42, 95%CI = 1.21-1.66, I2 = 18%, Q Cochran test p-value = 0.29) and revisional surgery (meta-analytical RR = 1.35, 95%CI = 1.12-1.62, I2 = 22%, Q Cochran test p = 0.21) were associated with higher risk of EPB. On average, patients with EPB were older than the remainder (MD for the mean age = 2.82 years, 95%CI = 0.97-4.67, I2 = 0.00%, Q Cochran test p = 0.46). Except for hypertension (meta-analytical RR = 1.33, 95%CI = 1.02-1.73, I2 = 66%, Q Cochran test p < 0.0001), comorbidities were not associated with a higher risk of EPB.
CONCLUSIONS: Preoperative risk factors, including age, gender, hypertension, and revisional bariatric surgery, are associated with early postoperative bleeding after RYGB. Further primary studies, with higher methodological quality, are required to detail more risk factors.
摘要：
目的：虽然减肥手术是肥胖的有效干预措施，它伴随着早期术后出血（EPB）等风险。确定这种并发症的术前危险因素可以帮助患者进行风险分层和优化。我们进行了系统评价和荟萃分析，以寻找Roux-en-Y胃旁路术（RYGB）术后早期出血的预测因素。
方法：我们进行了系统评价，搜索PubMed,科克伦图书馆,和WebofScience，直到2023年11月。我们进行了一项随机效应荟萃分析，以探讨与RYGB术后早期出血相关的术前危险因素。通过留一法分析探索异质性的来源。
结果：纳入了23项研究，包括232,488名患者。男性（荟萃分析RR=1.42，95CI=1.21-1.66，I2=18%，QCochran检验p值=0.29）和修正性手术（荟萃分析RR=1.35，95CI=1.12-1.62，I2=22％，QCochran检验p=0.21）与较高的EPB风险相关。平均而言,EPB患者的年龄大于其余患者（MD的平均年龄=2.82岁，95CI=0.97-4.67，I2=0.00%，QCochran检验p=0.46)。除高血压外（荟萃分析RR=1.33，95CI=1.02-1.73，I2=66％，QCochran试验p<0.0001),合并症与较高的EPB风险无关。
结论：术前危险因素，包括年龄,性别,高血压,和修订减肥手术，与RYGB术后早期出血有关。进一步的初步研究，具有更高的方法论质量，需要详细说明更多的风险因素。
方法：我们进行了系统评价，搜索PubMed,科克伦图书馆,和WebofScience，直到2023年11月。我们进行了一项随机效应荟萃分析，以探讨与RYGB术后早期出血相关的术前危险因素。通过留一法分析探索异质性的来源。
结果：纳入了23项研究，包括232,488名患者。男性（荟萃分析RR=1.42，95CI=1.21-1.66，I2=18%，QCochran检验p值=0.29）和修正性手术（荟萃分析RR=1.35，95CI=1.12-1.62，I2=22％，QCochran检验p=0.21）与较高的EPB风险相关。平均而言,EPB患者的年龄大于其余患者（MD的平均年龄=2.82岁，95CI=0.97-4.67，I2=0.00%，QCochran检验p=0.46)。除高血压外（荟萃分析RR=1.33，95CI=1.02-1.73，I2=66％，QCochran试验p<0.0001),合并症与较高的EPB风险无关。
结论：术前危险因素，包括年龄,性别,高血压,和修订减肥手术，与RYGB术后早期出血有关。进一步的初步研究，具有更高的方法论质量，需要详细说明更多的风险因素。
