Laparoscopic versus Open Obesity Surgery: A Meta-Analysis of Pulmonary Complications

被引:28
|
作者
Antoniou, Stavros Athanasios [1 ,2 ]
Antoniou, George Athanasios [3 ]
Koch, Oliver Owen [4 ]
Koehler, Gernot [4 ]
Pointner, Rudolph [5 ]
Granderath, Frank-Alexander [1 ]
机构
[1] Hosp Neuwerk, Ctr Minimally Invas Surg, Monchengladbach, Germany
[2] Univ Hosp Heraklion, Dept Gen Surg, Iraklion, Greece
[3] Newcastle Tyne Hosp NHS Fdn Trust, Freeman Hosp, Northern Vasc Ctr, Dept Vasc Surg, Newcastle Upon Tyne, Tyne & Wear, England
[4] Sisters Charity Hosp, Dept Gen Surg, Linz, Austria
[5] Hosp Zell am See, Dept Gen Surg, Zell Am See, Austria
关键词
Obesity; Laparoscopy; Pulmonary; Complication; Pneumonia; Morbidity; OPEN GASTRIC BYPASS; INTRAOPERATIVE VENTILATORY STRATEGIES; REVERSE TRENDELENBURG POSITION; MORBIDLY OBESE; BILIOPANCREATIC DIVERSION; RESPIRATORY MECHANICS; BARIATRIC SURGERY; GAS-EXCHANGE; PNEUMOPERITONEUM; TRIAL;
D O I
10.1159/000371749
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The clinical effects of laparoscopy in the pulmonary function of obese patients have been poorly investigated in the past. A systematic review was undertaken, with the objective to identify published evidence on pulmonary complications in laparoscopic surgery in the obese. Outcome measures included pulmonary morbidity, pulmonary infection and mortality. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) with 95% confidence interval (CI). A total of 6 randomized and 14 observational studies were included, which reported data on 185,328 patients. Pulmonary complications occurred in 1.6% of laparoscopic and in 3.6% of open procedures (OR 0.45, 95% CI 0.34-0.60). Pneumonia was reported in 0.5% and in 1.1%, respectively (OR 0.45, 95% CI 0.40-0.51). Available evidence suggests lower pulmonary morbidity for laparoscopic surgery in obese patients; further quality studies are however necessary to consolidate these findings. (C) 2015 S. Karger AG, Basel
引用
收藏
页码:98 / 107
页数:10
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