减重手术是最有效、可持续的减重形式。大肠病理手术前进行减重手术可能改善术后结果。本研究旨在通过比较有无先前减重手术行大肠癌手术患者的术后并发症和医疗利用情况，以评估两者之间的差异。我们从全国住院数据库中筛选出2015年至2019年接受大肠癌切除的成年患者，根据其减重手术史进行分层。根据人口统计学、手术和医院特征进行4:1最近邻匹配的倾向性分数匹配。主要研究结果为术后并发症。次要研究结果包括系统特异性的术后并发症、术后死亡率、住院时间、住院总费用和出院情况。采用McNemar检验和Wilcoxon配对符号秩检验进行数据分析。 经过倾向性分数匹配后，纳入了1197名未进行过减重手术的患者和376名先前接受过减重手术的患者。先前接受过减重手术的患者整体住院术后并发症减少了6.5%（19.1% vs 25.6%，P < .0001），住院费用减少了$5256（$70,344 vs $75,600，P = .034），出院时更有可能返家（72.9% vs 63.9%，P < .0001）。 在非减重性腹部手术前应进一步评估减重手术和其他快速有效的体重减轻方式，如极低能量饮食，以优化肥胖患者的术前状态。减重手术和其他形式的快速有效减重方法在非减重性腹部手术前的优化中值得进一步探究。 版权所有 © 2023 Elsevier Inc. 版权所有。

Bariatric surgery is the most effective and sustainable form of weight loss. Bariatric surgery before elective operations for colorectal pathology may improve postoperative outcomes. To compare patients with and without prior bariatric surgery undergoing surgery for colorectal cancer in terms of postoperative morbidity and health care use.Adult patients undergoing resection for colorectal cancer from 2015 to 2019 were identified from the National Inpatient Sample. Patients were stratified according to their history of bariatric surgery. Propensity score matching with 4:1 nearest-neighbor matching was performed according to demographic, operative, and hospital characteristics. The primary outcome was postoperative morbidity. Secondary outcomes included system-specific postoperative complications, postoperative mortality, postoperative length of stay, total admission health care cost, and post-discharge disposition. McNemar's test and Wilcoxon matched-pairs signed-rank test were performed.After propensity score matching, 1,197 patients without prior bariatric surgery and 376 patients with prior bariatric surgery were included. Patients with prior bariatric surgery had an absolute reduction of 6.5% in overall in-hospital postoperative morbidity (19.1% vs 25.6%, P < .0001), a $5,256 decrease in hospitalization cost ($70,344 vs $75,600, P = .034), and were more likely to be discharged home after their index operation (72.9% vs 63.9%, P < .0001).Bariatric surgery before surgery for colorectal cancer may be associated with decreased postoperative morbidity and health care use. Bariatric surgery and other forms of rapid and effective weight loss, such as very low-energy diets, should be evaluated further for the optimization of obese patients before nonbariatric abdominal surgery.Copyright © 2023 Elsevier Inc. All rights reserved.