PDF(Pubmed)
Abstract：
Background/Objectives: Bariatric surgery is a central cornerstone in obesity treatment. We aimed to assess the impact of diabetes on the postoperative outcomes of bariatric surgery and compare three techniques: sleeve gastrectomy, Roux-en-Y, and gastric banding. Methods: We extracted data from the National Inpatient Sample (2015-2019) using ICD codes. The primary outcome was postoperative mortality. Secondary outcomes were major bleeding, atrial fibrillation, and acute renal failure. Results: Among patients who underwent sleeve gastrectomy, diabetes was associated with a higher adjusted risk of mortality (aOR 2.07 [1.36-3.16]), atrial fibrillation, and acute renal failure, but a similar risk of bleeding. Among patients who underwent Roux-en-Y, diabetes did not increase mortality and bleeding risk. Still, it was associated with a higher risk of atrial fibrillation and acute renal failure. Among patients who underwent gastric banding, diabetes was only associated with a higher risk of bleeding. When comparing the three techniques in diabetes patients, Roux-en-Y was significantly associated with higher mortality and acute renal failure risk when compared to the other procedures. Bleeding was more common in Roux-en-Y than in Sleeve. Conclusions: In total, diabetes is associated with worse postoperative outcomes in bariatric surgery, regardless of the technique. Among diabetes patients, Roux-en-Y was associated with the highest mortality and morbidity.
摘要：
背景/目的：减肥手术是肥胖治疗的核心基石。我们旨在评估糖尿病对减肥手术后结局的影响，并比较三种技术：袖状胃切除术，Roux-en-Y,和胃束带。方法：我们使用ICD代码从全国住院患者样本（2015-2019）中提取数据。主要结果是术后死亡率。次要结果是大出血，心房颤动,和急性肾衰竭.结果：在接受袖状胃切除术的患者中，糖尿病与较高的调整后死亡风险相关（aOR2.07[1.36-3.16]），心房颤动,急性肾衰竭,但有类似的出血风险.在接受Roux-en-Y的患者中，糖尿病并未增加死亡率和出血风险.尽管如此，它与房颤和急性肾衰竭的高风险相关.在接受胃束带术的患者中，糖尿病仅与较高的出血风险相关.当比较糖尿病患者的三种技术时，与其他手术相比，Roux-en-Y与更高的死亡率和急性肾衰竭风险显着相关。出血在Roux-en-Y中比在Sleeve中更常见。结论：总的来说，糖尿病与减肥手术的术后预后较差有关，不管技术。在糖尿病患者中，Roux-en-Y与最高的死亡率和发病率相关。
