Postbariatrische Straffungsoperationen: Eine Analyse postoperativer Komplikationen und Einflussfaktoren

Zusammenfassung

Hintergrund

Die steigende Prävalenz von Adipositas und bariatrischen Operationen hat zu einem erhöhten Bedarf an körperstraffenden Wiederherstellungsoperationen (WHOs) geführt. Trotz zunehmender Expertise und etablierter chirurgischer Techniken bleiben postoperative Komplikationen eine bedeutende Herausforderung. Diese Studie analysiert postoperative Komplikationen und mögliche Risikofaktoren.

Methoden

In einer prospektiven Kohortenstudie wurden über einen Zeitraum von 2015 bis 07/2024 Daten von 606 Patient:innen erhoben, die sich wiederherstellenden Straffungsoperationen unterzogen. Analysiert wurden, mit Fokus auf abdominelle Straffungsoperationen, Komplikationsraten sowie deren Einflussfaktoren, darunter BMI, Resektionsgewicht und Art des Gewichtsverlusts (bariatrische Operation vs. Lifestyle-Änderung). Statistische Auswertungen erfolgten mittels Mann-Whitney-U-Test, Chi-Quadrat-Test und ROC-Kurvenanalyse.

Ergebnisse

Die Gesamtrate der postoperativen Komplikationen betrug 37,5%, wobei Wundheilungsstörungen mit 21,5% dominierten. Patient:innen nach bariatrischen Operationen zeigten signifikant mehr Komplikationen als solche mit Gewichtsverlust durch Lifestyle-Änderungen (p=0,029). Ein höherer BMI zum Operationszeitpunkt (Cut-off: 31) und ein überproportionales Resektionsgewicht – relativ zum BMI (Index>105) waren signifikante Prädiktoren für postoperative Komplikationen (p<0,001).

Schlussfolgerung

Die Ergebnisse verdeutlichen die Bedeutung einer individuellen präoperativen Planung, die unter anderem BMI und das Resektionsausmaß berücksichtigt. Ein Resektionsgewicht-BMI-Index könnte zukünftig als Instrument zur Risikoeinschätzung beim abdominellen Straffungsoperationen dienen, um chirurgische Ergebnisse zu optimieren, Komplikationen zu minimieren und ein transparenteres Benchmarking zu ermöglichen.

Abstract

Background

The rising prevalence of obesity and bariatric surgery has led to an increased demand for reconstructive body contouring procedures. Despite growing expertise and well-established surgical techniques, postoperative complications remain a significant challenge. This study analyses postoperative complications and potential risk factors.

Methods

In a prospective cohort study, data from 606 patients who had undergone reconstructive body contouring surgery were collected between 2015 and July 2024. Focusing on abdominal contouring procedures, we analysed complication rates and their influencing factors, including BMI, resection weight, and type of weight loss (bariatric surgery vs. lifestyle modification). Statistical analysis was performed using the Mann–Whitney U test, chi-square test, and ROC curve analysis.

Results

The overall rate of postoperative complications was 37.5%, with wound healing disorders being most common (21.5%). Patients who had undergone bariatric surgery experienced significantly more complications than those who had lost weight through lifestyle changes (p=0.029). A higher BMI at the time of surgery (cut-off: 31) and a disproportionately high resection weight relative to BMI (index>105) were significant predictors of postoperative complications (p<0.001).

Conclusion

These findings underscore the importance of individualised preoperative planning that accounts for factors such as BMI and resection volume. A resection weight-to-BMI index may serve as a useful tool for future risk assessment in abdominal contouring surgery, with the potential to optimise surgical outcomes, minimise complications, and facilitate transparent benchmarking.

Schlüsselwörter

Postbariatrische Chirurgie - Komplikationen - Straffungsoperationen - Resektionsgewicht - BMI

Keywords

BMI - post-bariatric surgery - complications - resection weight - body-contouring surgery

Publication History

Received: 01 February 2025

Accepted: 30 April 2025

Article published online:
22 May 2025

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